Chahade W H, Soares V de F, Guimarães T, Berbert S O, Szwarc I S, Levi G C
Department of Rheumatology, Hospital do Servidor Público Estadual de São Paulo, Brazil.
Sao Paulo Med J. 1994 Jul-Sep;112(3):587-90. doi: 10.1590/s1516-31801994000300003.
Few cases of AIDS associated to manifestations suggesting Behçet's syndrome have been reported. This case is of a young married woman who presented, during a period of 7 years, clinical manifestations consistent with the late diagnosis of Behçet's syndrome, when she developed recurrent lymphomonocytic meningoencephalitis. At this time, she was found to be infected by HIV-1. Immunosuppressive doses of glucocorticoid produced an unsatisfactory response and she evolved to death due to CNS toxoplasmosis. The latter diagnosis was presumed on the basis of magnetic resonance imaging findings and proved by necropsy after her third hospital stay. One of the factors hindering the appropriate diagnosis was the low level of CD4 and the CD4/CD8 ratio, sometimes observed in active Behçet's syndrome and higher than those observed in patients with this severe opportunistic infection. No information about the exact period of time she had been infected with HIV-1 is available. So, we do not know whether both diseases were overlooked, if the patient, infected by HIV-1, developed an unusual clinical feature consistent with Behçet's Behçet's syndrome, and subsequently evolved to AIDS.
仅有少数艾滋病合并疑似白塞病表现的病例被报道。本病例为一名年轻已婚女性，在7年期间出现了与白塞病晚期诊断相符的临床表现，当时她患上了复发性淋巴细胞性脑膜脑炎。此时，发现她感染了HIV-1。免疫抑制剂量的糖皮质激素治疗效果不佳，她最终因中枢神经系统弓形虫病死亡。后者的诊断是根据磁共振成像结果推测的，并在她第三次住院后经尸检证实。阻碍准确诊断的因素之一是CD4水平及CD4/CD8比值较低，这在活动性白塞病中有时也会出现，且高于患有这种严重机会性感染的患者。目前没有关于她感染HIV-1的确切时间的信息。所以，我们不知道这两种疾病是否都被忽视了，不知道感染了HIV-1的患者是否出现了与白塞病相符的异常临床特征，随后又发展为艾滋病。
