Rituximab as an effective therapeutic option in refractory Neuro-Behçet syndrome

Christian Garcia-Estrada; Adriana Casallas-Vanegas; Indhira Zabala-Angeles; Enrique Gomez-Figueroa; Verónica Rivas-Alonso; José Flores-Rivera

doi:10.1016/j.jneuroim.2020.577308

Rituximab as an effective therapeutic option in refractory Neuro-Behçet syndrome

J Neuroimmunol. 2020 Jun 26:346:577308. doi: 10.1016/j.jneuroim.2020.577308. Online ahead of print.

Authors

Christian Garcia-Estrada¹, Adriana Casallas-Vanegas², Indhira Zabala-Angeles², Enrique Gomez-Figueroa², Verónica Rivas-Alonso², José Flores-Rivera³

Affiliations

¹ Multiple sclerosis and Demyelinating disorders Clinic, National Institute of Neurology and Neurosurgery, Mexico City, Mexico. Electronic address: christianalan.cg@gmail.com.
² Multiple sclerosis and Demyelinating disorders Clinic, National Institute of Neurology and Neurosurgery, Mexico City, Mexico.
³ Multiple sclerosis and Demyelinating disorders Clinic, National Institute of Neurology and Neurosurgery, Mexico City, Mexico; Head of Neurology Department National Institute of Neurology and Neurosurgery, Mexico City, Mexico.

PMID: 32619893
DOI: 10.1016/j.jneuroim.2020.577308

Abstract

Introduction: Behçet's disease (BD) is an inflammatory disease of unknown etiology with periods of relapses and remissions. Neuro-Behçet syndrome (NBS) is one of the main causes of long-term morbidity and mortality, making its prompt recognition and early treatment fundamental to achieving a better outcome. Currently there are no treatment guidelines either for BS or NB, making the management of these patients particularly difficult.

Case presentation: We present the case report of a patient with pseudo-tumoral lesion and myelitis refractory to steroids and cyclophosphamide who successfully showed remission after treatment with an anti-CD20 therapy.

Conclusion: This is the first report of concomitant pseudo-tumoral lesion and myelitis secondary to BS. We found rituximab treatment to be a safe and effective therapeutic option for NB supported by the radiological and clinical improvement achieved in our patient.

Keywords: Myelitis; Neuro-Behçet; Pseudotumoral lesion; Rituximab.