Treatment of Behçet's Disease with Parenchymal Central Nervous System Involvement
This protocol addresses the management of Behçet's syndrome with parenchymal central nervous system involvement — a specific clinical presentation that includes severe disease at onset, persistent or relapsing courses, and chronic progressive forms.
The scenario covered here is Behçet's syndrome with parenchymal central nervous system involvement. This includes patients with severe parenchymal involvement at onset, those with persistent or relapsing disease, and those with chronic progressive nervous system involvement.
Therapeutic Approach — Partial Overview
The management strategy for this presentation includes monoclonal anti-TNF antibody therapy in indicated cases. Patient selection criteria, clinical decision points, and the complete sequencing are detailed in the full structured protocol.
References
DOI: 10.1136/annrheumdis-2018-213225
- Acute attacks of parenchymal involvement should be treated with high-dose glucocorticoids followed by slow tapering, together with immunosuppressives such as azathioprine.
- Monoclonal anti-TNF antibodies should be considered in severe disease as first line or in refractory patients.
- Patients who have severe parenchymal involvement at onset, those who have persistent or relapsing disease despite corticosteroids and azathioprine and patients with chronic progressive nervous system involvement that is a more severe form of parenchymal involvement may benefit from monoclonal anti-TNF antibodies.
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