Atypical granulomatous inflammation in patients with Behçet’s disease
Purpose
To describe cases of atypical granulomatous inflammation in patients with Behçet’s disease (BD).
Methods
We retrospectively reviewed five cases of atypical granulomatous inflammation in patients with BD. Data were collected from patients' charts, including slit-lamp anterior segment photographs, fundus findings, general conditions, and treatments received.
Results
We present a case series of five patients who presented with granulomatous keratic precipitates (KPs) during the course of BD. All the patients were diagnosed as having Behçet’s disease on the basis of the findings of ocular inflammatory attacks, medical history, and extraocular manifestations. Atypical granulomatous inflammation was observed under treatment with biological agents in three cases (infliximab in 2 and adalimumab in 1) and colchicine in 2 cases. All the cases of granulomatous inflammation were unilateral. Three patients manifested mutton-fat KPs, and the remaining two patients had medium-sized KPs. Three cases were treated with local steroid eye drops, one case was treated with increased doses of methotrexate and subtenon triamcinolone acetonide injections, and another case was treated with infliximab administration scheduled for the same day. These granulomatous KPs disappeared rapidly in response to the treatment without antimicrobial agents.
Conclusion
Granulomatous KPs could occur during the course of BD. These clinical characteristics must be considered to make an accurate diagnosis when atypical granulomatous inflammation is observed in patients with BD.
Conflict of interest
No
Authors 1
Last name
IWAHASHI
Initials of first name(s)
C
Department
Department of Ophthalmology, Kindai University Faculty of Medicine
City
Osakasayama
Country
Japan
Authors 2
Last name
OHGURO
Initials of first name(s)
N
Department
Department of Ophthalmology, Japan Community Health Care Organization Osaka Hospital
City
Osaka
Country
Japan
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