Behçet Disease Health Article

Treatment

Treatment is focused on the symptoms. Several medications are available to minimize discomfort caused by these symptoms.

Most treatment efforts attempt to reduce pain and inflammation. Corticosteroids such as Prednisone are prescribed since they are effective at regulating inflammatory responses. These may be administered as injections, pills, or creams. Immunosuppresant drugs such as cyclosporine, azathioprine or cyclophosphamide help suppress the immune system's response to a less-active state. Both corticosteroids and immunosuppresants can have serious side effects. Patients must be closely monitored by a physician while using these medications.

The use of interferon alpha 2a and 2b has been an effective treatment for ulcers and arthritis in patients who were less responsive to standard treatment regimens. Thalidomide has also shown potential as a treatment for BD. A complication of thalidomide is neuropathy. Thalidomide should not be used by women since it causes severe birth defects in fetuses.

Recovery and rehabilitation

Unlike most diseases, BD has symptoms that periodically flare up and then disappear for a period of time. As a result, patients may have long intervals with no complications. After treatment for active symptoms, patients usually require rest due to fatigue. Moderate exercise is also recommended to improve circulation and muscle strength.

Clinical trials

As of early 2004, the National Eye Institute was sponsoring two studies and recruiting patients with Behçet disease.

"Evaluation and Treatment of Patients with Inflammatory Eye Diseases" (study number 000204) evaluates patients with inflammatory eye diseases and the success of current therapies. "Biological Markers in Retinal Vasculitis" (study number 030068) is attempting to isolate biological markers related to primary retinal vasculitis by evaluating patients with differing initial causes of the disease.

Additional information on either of these studies can be found at the National Eye Institute (NEI), Patient Recruitment and Public Liaison Office, 9000 Rockville Pike, Bethesda, Maryland, 20892, (800) 411-1222, TTY (866) 411-1010.

Prognosis

For most patients, the prognosis of Behçet disease is good. Individuals typically experience periods of active symptoms followed by periods of remission in which there are no symptoms. The length of these intervals varies, with ulcerous outbreaks lasting a few weeks and other symptoms occurring for longer durations. With proper treatments and medication, patients can continue to lead active lifestyles in most cases.

Development of vascular or neurological complications often indicates a poorer prognosis. Blindness due to ocular inflammation is also prevalent in patients with BD.

Special concerns

In cases in which a patient becomes visually impaired, major lifestyle changes take place. The patient will have to learn adaptive behaviors and new forms of communication. Leader dog assistance or additional caregiver support are also considerations.

BOOKS

Lee, Sungnack. Behçet's Disease: A Guide to Its Clinical Understanding. New York: Springer Verlag, 2001.

Zeis, Joanne. Essential Guide to Behçet's Disease. Uxbridge, MA: Central Vision Press, 2003.

PERIODICALS

Okada, A. A. "Drug Therapy in Behçet's Disease." Ocular Immunology and Inflammation (June 2001): 85–91.

WEBSITES

Lee, Sungnack. "Behçet Disease." EMedicine. February 18, 2004 (May 17, 2004). <http://www.emedicine.com/derm/topic49.htm>.

"Types of Vasculitis: Behçet's Disease." The Johns Hopkins Vasculitis Center Website. The Johns Hopkins University. 2002 (May 17, 2004). <http://vasculitis.med.jhu.edu/typesof/behcets.html>.

ORGANIZATIONS

American Behçet's Disease Association. P.O. Box 19952, Amarillo, TX 79114. (800) 724-2387. jbadillo@behcets.com. <http://www.behcets.com>.

Behçets Organisation Worldwide. P.O. Box 27, Watchet, Somerset TA23 0YJ, United Kingdom. information@behcetsuk.org. <http://behcets.org>.

National Arthritis and Musculoskeletal and Skin Diseases Information Clearinghouse. 1AMS Circle, Bethesda, MD 20892. (301) 495-4484 or (877) 226-4267; Fax: (301) 718-6366. niamsinfo@mail.nih.gov. <http://www.niams.nih.gov>.

Stacey L. Chamberlin