Neurobehçet, multiple sclerosis or overlap syndrome? A case report
According to the “McDonald criteria”, multiple sclerosis (MS) diagnosis requires the demonstration of dissemination in time (DIT) and in space (DIS) and no better explanation .
We report the case of a 25-year-old woman came to our attention complaining of sudden decrease of vision in both eyes and orbital pain increased by eye movements. Few years before, she had been diagnosed with Behçet’s disease (BD) on the basis of recurrent bilateral uveitis, oral aphthosis, positive pathergy test and positive HLAB51 and treated with methotrexate, infliximab, and prednisone, all suspended for personal decision from 5 years. At the age of 18, after 3 years of therapy with infliximab and 8 years after the diagnosis of BD, she reported a right sensory hemisyndrome and a brain MRI (without gadolinium for allergy) showed T2-weighted hyperintense lesions in the corpus callosum, bilateral centrum semiovale, and corona radiata.
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflicts of interest.
- 1.Thompson AJ, Banwell BL, Barkhof F, Carroll WM, Coetzee T, Comi G, Correale J, Fazekas F, Filippi M, Freedman MS, Fujihara K, Galetta SL, Hartung HP, Kappos L, Lublin FD, Marrie RA, Miller AE, Miller DH, Montalban X, Mowry EM, Sorensen PS, Tintoré M, Traboulsee AL, Trojano M, Uitdehaag BMJ, Vukusic S, Waubant E, Weinshenker BG, Reingold SC, Cohen JA (2018) Diagnosis of multiple sclerosis: 2017 revisions of the McDonald criteria. Lancet Neurol 17:162–173CrossRefPubMedGoogle Scholar
- 12.Massacesi L, Tramacere I, Amoroso S, Battaglia MA, Benedetti MD, Filippini G, la Mantia L, Repice A, Solari A, Tedeschi G, Milanese C (2014) Azathioprine versus beta interferons for relapsing-remitting multiple sclerosis: a multicentre randomized non-inferiority trial. PLoS One 9:e113371CrossRefPubMedPubMedCentralGoogle Scholar
- 13.Casetta I, Iuliano G, Filippini G (2007) Azathioprine for multiple sclerosis. Cochrane Database Syst Rev 17:CD003982Google Scholar