Parankimal ve non-parankimal tutulum gösteren nöro-behçet hastalığı olguları

Nöro-Behçet Hastalığı (NBH) parankimal ve non-parankimal tutulum olarak sınıflandırılmıştır. Tanı aftöz lezyonların yanında göz, cilt bulguları, paterji testi pozitifliği ve vasküler lezyonların tanınması ile konmaktadır. Bu yazımızda kliniğimize farklı nörolojik yakınmalarla başvuran ve klinik değerlendirmeler sonucunda NBH tanısı alan 3 olgu sunmayı amaçladık. Birinci olgumuzda tekrarlayan oral aftlar, genital skar, paterji testi ve HLA B51 pozitifliği, magnetic rezonans (MR) tutulum özellikleri ve öncesinde Behçet hastalığı (BH) tanısı almış olması nedeniyle NBH tanısı konuldu. İkinci olgumuzda non-parankimal tutulum mevcuttu ve yaygın serebral venöz tromboz saptandı. Antikoagülan kullanımı ile gastrointestinal system (GİS) kanama gelişmesi BH’nın GİS tutulumu ve olası komplikasyonlar açısından uyarıcıydı. Son olgumuzda yılda 3 ten fazla oral aft öyküsü, aralıklı artralji yakınmaları ve parankimal merkezi sinir sistemi tutulumu mevcuttu ve HLA B51 pozitifti. Baş ağrısı, bilinç değişiklikleri veya akut nörolojik defisitler gibi farklı klinik tablolarla başvurabilen olgularda BH açısından gerekli öykü ve muayenenin detaylı yapılması gerektiğini hatırlatmak ve ülkemizde sık görülen bu hastalığın önemine vurgu yapmak istedik.

Anahtar Kelimeler:

Behçet hastalığı, nöro-behçet hastalığı, santral sinir sistemi, serebral venöz tromboz

Neuro-behçet disease cases with parenchymal and non-parenchymal involvement

Neuro-Behçet’s Disease (NBD) is classified as parenchymal and non-parenchymal involvement. The diagnosis is made by the diagnosis of aphthous lesions, as well as by eye, skin findings, positive pathergy test and vascular lesions. In this article, we aimed to present three cases who presented to our clinic with different neurological complaints and were diagnosed with NBH as a result of clinical evaluations. Our first patient was diagnosed with NBH because of recurrent oral aphthae, genital scar, pathergy test and HLA B51 positivity, magnetic resonance (MR) involvement, and previous Behçet’s disease (BD). In our second case, non-parenchymal involvement was present and widespread cerebral venous thrombosis was detected. The development of gastrointestinal system bleeding with anticoagulant stimulation was associated with GIS involvement and was stimulatory in terms of possible complications of GI. In our last case, there were more than 3 oral aphthae per year, intermittent arthralgia complaints and parenchymal central nervous system involvement and HLA B51 was positive. We wanted to emphasize the need for detailed history and examination of BD in patients with headache, consciousness changes or acute neurological deficits and emphasize the importance of this disease which is common in our country.

Keywords:

Behçet's disease, neuro-behçet’s disease, central nervous system, cerebral venous thrombosis,

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