Objectives
To describe the long-term clinical course of each manifestation of Behçet’s disease (BD) and clarify factors involved in oral ulcer (OU) remission using clinical information of BD patients.
Methods
We retrospectively studied 155 BD patients visiting our hospital (1989–2020). We defined remission criteria for each manifestation and examined long-term clinical changes. Classification and regression trees and multivariable analyses were performed to investigate OU prognostic factors; hazard ratios were used to assign scores to prognostic factors deemed significant (OU prognosis score: OuP score). Risk stratification was examined by dividing the OuP scores into four stages.
Results
OUs appeared earliest, with the slowest decline in prevalence observed post-BD diagnosis. OU presence was the most common factor inhibiting complete remission. Young age at OU onset, never smoker, presence of genital ulcers, positive pathergy test, no usage of tumour necrosis factor inhibitors or of immunosuppressants, and long-term non-treatment or symptomatic treatment for OUs were poor OU prognostic factors. Based on multivariable analysis, the area under the curve of the OuP score to predict OU prognosis was 0.678.
Conclusions
Remission criteria for each symptom clarified that OU had the greatest impact on complete BD remission. Faster OU remission was associated with earlier OU therapeutic intervention other than symptomatic treatment.
Rheumatoid meningitis, a very rare complication, is not well-recognised, and there are few reports describing its treatment. We report the case of a 74-year-old Japanese woman who was diagnosed with rheumatoid meningitis by characteristic brain magnetic resonance imaging (MRI) and was successfully treated with glucocorticoids. We observed fluid-attenuated inversion recovery and diffusion-weighted imaging hyperintensity, which had a meningeal gadolinium-enhancing characteristic of rheumatoid meningitis. We suggest that it is possible to diagnose this disease based on characteristic MRI findings and treat patients early using glucocorticoids.
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