Abstract
We report a case of Behçet disease in which neuropsychiatric symptoms developed with the administration of infliximab (IFX) for an ocular lesion. A 27-year-old man had refractory iridocyclitis, retinouveitis, and recurrent aphthous stomatitis at the age of 25.He was diagnosed with Behçet disease. Because his ocular lesion was resistant to conventional immunosuppressive agents such as corticosteroids, cholchicine or cyclosporine, IFX (5mg/kg/6～8weeks) was administered. IFX was effective for his ocular lesion. Fifteen months after starting the IFX treatment, he was admitted to our hospital with complaints of pyrexia, headache, and slurredspeech. Although brain MRI revealed no abnormal lesions, the CSF IL-6 level was markedly elevated (172pg/ml: reference value＜6.0pg/ml). Based on these, we diagnosed him with neuro-Behçet’s disease (NBD). We treated him with steroid pulse therapy followed by a 40mg daily administration of prednisolone. After these treatments, his symptoms improved and the IL-6 level decreased. There are no reports of NBD developed during IFX therapy, though there are some reports in which anti-TNF-α therapy seems to be effective for patients with refractory NBD. This case suggests that infliximab may not be able to fully prevent the development of NBD.
