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神经贝赫切特病被误诊和误治为多发性硬化症:一个具有欺骗性的伪装者。

Neuro-Behcet's disease misdiagnosed and treated as multiple sclerosis: a deceiving masquerader.

机构信息

Neurology Section, Department of Medicine, Aseer Central Hospital, Abha, Saudi Arabia.

Department of Neuroscience, King Faisal Specialist Hospital & Research Centre, Jeddah, Saudi Arabia.

出版信息

Int J Neurosci. 2024 Oct;134(10):1134-1138. doi: 10.1080/00207454.2023.2246099. Epub 2023 Aug 11.

Abstract

Behcet's disease is a chronic polysymptomatic systemic vasculitis disorder of unknown etiology characterized by several clinical manifestations in multiple organ systems. Involvement of the nervous system occurs in ∼9% of patients with Behcet's disease (ranging from 3 to 30%). Neuro-Behcet's disease is a great masquerader of multiple sclerosis. Diagnosing this disorder might be challenging, especially in a patient who does not fulfill the criteria of Behcet's disease while having a neurological presentation. We report a case of neuro-Behcet's disease who was misdiagnosed as having multiple sclerosis for many years and started on unnecessary disease-modifying therapy for multiple sclerosis. A thorough history, physical examination, and systematic investigations are mandatory to differentiate between these two conditions. Our case presentation raises awareness of the importance of differentiating between these two conditions since the consequences of misdiagnosis are catastrophic. The main challenges differentiating between multiple sclerosis and neuro-Behcet's are clinical and paraclinical, including neuroimaging.

摘要

贝赫切特病是一种慢性多系统综合征性血管炎疾病,病因不明,其特征是在多个器官系统出现多种临床表现。神经系统受累发生在约 9%的贝赫切特病患者中(范围为 3%至 30%)。神经贝赫切特病是多发性硬化症的一个重要伪装者。诊断这种疾病可能具有挑战性,特别是在一个没有满足贝赫切特病标准但出现神经系统表现的患者中。我们报告了一例神经贝赫切特病患者,他多年来被误诊为多发性硬化症,并开始接受不必要的多发性硬化症治疗。为了区分这两种情况,必须进行详细的病史询问、体格检查和系统调查。我们的病例介绍提高了区分这两种情况的重要性,因为误诊的后果是灾难性的。区分多发性硬化症和神经贝赫切特病的主要挑战是临床和辅助检查,包括神经影像学。

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