CH14: Behcet Disease

Question 1

Triad of Behcet Disease

Answer 1

Recurrent oral ulcers
genital ulcers
Hypopyon iritis

Question 2

Microoganisms studied to cause Behcets?

Answer 2

Streptococcal stains (Strep sanguinis)
Herpes simmplex virus type 1
H pylori
Hepcidin (antibacterial peptide)
HSP 65

Question 3

Two different patterns of CNS involvements in Behcet

Answer 3

Parenchymal (82%)
Neurovascular (18%)

Question 4

Neuropathologic findings in Neurobehcet?

Answer 4

Perivascular cuffing, around small veins with micro hemorrhages, infarctions, macrophage infiltration

Absence of fibrinoid necrosis, thrombosis or endothelial degeneration

Question 5

When does meningoencephalitis of neuro-Behcet begin?

Answer 5

Months or years after onset of mucocutaneous manifestations, often develops exacerbations of non- neurologic symptoms

Question 6

MRI finding of Behcet?

Answer 6

Increased signal intensity on T2-weighted images, involving the brainstem, basal ganglia and hypothalamus

Brain atrophy (correlated with clinical symptoms and CSF levels of IL6)

Question 7

CSF Finding of Behcet?

Answer 7

CSF pleocytosiis with lymphocytic predominance, with absence of more than two oligoclonal immunoglobulin G (IgG) bands

Question 8

T/F CNS vasculature is RARE in Behcet?

Answer 8

YES. Arterial involvement is extremely rare.

Question 9

Most common feature of vasculo-Behcet disease?

Answer 9

Large cerebral veins and sinus thrombosis

Question 10

Most common veins affected by Neuro-behcet?

Answer 10

superior sagittal sinus
lateral sinuses
cortical veins
veins of the galenic system
cavernous sinus

Question 11

Better prognosis? Arterial or venous vasculo-Behcet?

Answer 11

Venous

Question 12

Considered to be responsible for aneurysm or pseudoaneurysm?

Answer 12

Vasculitis of the vasa vasorum

Question 13

Pathologic findings in hemorrhagic strokes from Neuro-Behcet?

Answer 13

Active arteritis followed by the destruction of the media and fibrosis