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Rinsho Shinkeigaku ; 58(2): 105-110, 2018 Feb 28.
Article in Japanese | MEDLINE | ID: mdl-29386494

ABSTRACT

A 77-year-old man with a history of cigarette smoking had suffered from vertigo and depression repeatedly for twelve years. He gradually developed bradykinesia in the past half decade and fell down 3 times in the last half year. On admission, he presented with cerebellar ataxia and bulbar symptoms. Brain MRI showed atrophy in the cerebellum and brainstem. 123I-IMP SPECT showed hypoperfusion bilaterally in the cerebellum. Blood examinations showed various elevated inflammatory values and positive for HLA-B51. Cerebrospinal fluid (CSF) revealed aseptic meningitis and increased IL-6 levels. Therefore, we strongly suspected that he had chronic progressive neuro-Behcet's disease (CPNBD), clinically. Systemic mucocutaneous symptoms appeared 1 month after starting treatments. Pathological findings of his skin biopsy were consistent with Behcet's disease. It should be kept in mind that both positive HLA-B51 and increased CSF IL-6 levels have the possibility of containing important clues in the diagnosis of CPNBD.


Subject(s)
Behcet Syndrome/diagnosis , Bulbar Palsy, Progressive/etiology , Cerebellar Ataxia/etiology , Aged , Atrophy , Behcet Syndrome/complications , Behcet Syndrome/pathology , Biomarkers/blood , Biomarkers/cerebrospinal fluid , Brain Stem/diagnostic imaging , Brain Stem/pathology , Cerebellum/blood supply , Cerebellum/diagnostic imaging , Cerebellum/pathology , Chronic Disease , Disease Progression , HLA-B51 Antigen/blood , Humans , Interleukin-6/cerebrospinal fluid , Magnetic Resonance Imaging , Male , Meningitis, Aseptic/etiology , Skin/pathology , Tomography, Emission-Computed, Single-Photon
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