Pseudotumoural presentation of neuro-Behcet's disease: case series and review of literature. - Inria - Institut national de recherche en sciences et technologies du numérique Access content directly
Journal Articles Rheumatology Year : 2012

Pseudotumoural presentation of neuro-Behcet's disease: case series and review of literature.

Abstract

OBJECTIVE: To describe the pseudotumoural presentation of neuro-Behçet's disease (NBD). METHODS: We report here the main characteristics, treatment and outcome of 23 patients (5 personal cases and 18 patients from the literature) with a pseudotumoural presentation of NBD. Pseudotumoural NBD patients were compared with 69 consecutive patients, with a classical form of NBD. RESULTS: The median age was 39 (range 27-48 years) years, with a male predominance (65.2%). Clinical features of the pseudotumoural NBD included hemi- or tetra-pyramidal symptoms (n = 20), headache (n = 17), cerebellar syndrome (n = 3), sphincter impotence (n = 3) and pseudobulbar signs (n = 2). CNS imaging showed pseudotumoural lesions mainly in the capsulo-thalamic area (69.6 vs 11.6% for classical NBD; P < 0.01). Histological analysis revealed necrotic lesions with perivascular inflammatory infiltrate without signs of tumoural or infectious lesions. Patients with pseudotumoural NBD had more severe initial disability status (Rankin's score ≥3 in 65.2 vs 24.7%; P < 0.01) and had a 3 years' longer duration between neurological signs and BD diagnosis (P = 0.01) compared with patients with classical NBD. Treatment consisted of CSs (n = 21, 95.5%) and immunosuppressive agents (n = 10, 35.7%) that led to complete clinical and imaging remission in 60.9% of patients. Two (8.7%) of the 23 patients with pseudotumoural NBD died of bedridden state complications. CONCLUSION: The pseudotumoural form of NBD is a rare and life-threatening condition.

Domains

Medical Imaging

Dates and versions

hal-00793700 , version 1 (22-02-2013)

Identifiers

Cite

Nicolas Noel, Marie Hutié, Bertrand Wechsler, Stéphane Vignes, Du Le Thi Huong-Boutin, et al.. Pseudotumoural presentation of neuro-Behcet's disease: case series and review of literature.. Rheumatology, 2012, 51 (7), pp.1216-1225. ⟨10.1093/rheumatology/ker449⟩. ⟨hal-00793700⟩
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