Doença de Behçet com envolvimento neurológico: relato de um caso em gestante

Nóvak, Edison Matos; Werneck, Lineu Cesar; Mora, Armando Heitor

doi:10.1590/S0004-282X1977000200007

Resumos

É relatada a ocorrência de doença de Behçet em uma gestante, tendo esta comprometimento ocular, oral, genital, neurológico e cutâneo. O líquido cefalorraqueano mostrava pleiocitose e elevação de gamaglobulina. O parto foi feito mediante cesareana ao 8 1/2 mês de gestação. O recém-nascido, até o 6º mês de idade estava normal. A paciente foi tratada com corticóide sistêmico e ocular. Houve boa evolução do caso, desaparecendo os sinais e sintomas; persistiu redução importante da acuidade visual. Os relatos de casos similares permitem supor que a gestação favoreceu a remissão do quadro clínico neste caso. Nos comentários são abordados os aspectos neurológicos e de tratamento da doença de Behçet.

A case of Behçet's disease in a pregnant patient is reported. The patient showed central nervous system involvement as well eyes, mouth, external genitalia and skin lesions. The neurological signs were cranial nerves palsies and pyramidal tract involvement. The cerebrospinal fluid showed hypercytosis and hyper-gammaglobulin. The patient was treated with sistemic dexamethasone and eye drops of atropine and fluorometolone. The delivery was by elective cesarean section at 8th and a half month of pregnancy. In the examination at 6 month-old the infant was normal. The patient improved but remained with important visual loss. The authors think that the pregnancy helped the partial recovery and the good evolution; similar cases have been reported in the literature. A rapid review about the central nervous system involvement and treatment of Behçet's disease is made.

Doença de Behçet com envolvimento neurológico: relato de um caso em gestante

Behçet's disease with neurological involvement: report of a case in a pregnant woman

Edison Matos Nóvak^I; Lineu Cesar Werneck^II; Armando Heitor Mora^I

^IResidente de Neurologia. epartamento de Clínica Médica da Universidade Federal do Paraná, Curitiba

^IIAuxiliar de ensino de Neurologia. epartamento de Clínica Médica da Universidade Federal do Paraná, Curitiba

RESUMO

É relatada a ocorrência de doença de Behçet em uma gestante, tendo esta comprometimento ocular, oral, genital, neurológico e cutâneo. O líquido cefalorraqueano mostrava pleiocitose e elevação de gamaglobulina. O parto foi feito mediante cesareana ao 8 1/2 mês de gestação. O recém-nascido, até o 6º mês de idade estava normal. A paciente foi tratada com corticóide sistêmico e ocular. Houve boa evolução do caso, desaparecendo os sinais e sintomas; persistiu redução importante da acuidade visual. Os relatos de casos similares permitem supor que a gestação favoreceu a remissão do quadro clínico neste caso. Nos comentários são abordados os aspectos neurológicos e de tratamento da doença de Behçet.

SUMMARY

A case of Behçet's disease in a pregnant patient is reported. The patient showed central nervous system involvement as well eyes, mouth, external genitalia and skin lesions. The neurological signs were cranial nerves palsies and pyramidal tract involvement. The cerebrospinal fluid showed hypercytosis and hyper-gammaglobulin. The patient was treated with sistemic dexamethasone and eye drops of atropine and fluorometolone. The delivery was by elective cesarean section at 8th and a half month of pregnancy. In the examination at 6 month-old the infant was normal. The patient improved but remained with important visual loss. The authors think that the pregnancy helped the partial recovery and the good evolution; similar cases have been reported in the literature. A rapid review about the central nervous system involvement and treatment of Behçet's disease is made.

Texto completo disponível apenas em PDF.

Full text available only in PDF format.

Disciplina de Neurologia do Departamento de Clínica Médica da Universidade Federal do Paraná, Curitiba:

Disciplina de Neurologia - Universidade Federal do Paraná - Hospital de Clinicas - Rua General Carneiro s/nº - 13º andar - 80.000 Curitiba PR - Brasil.

1. ALAJOUANINE, Th.; CASTAIGNE, P.; LHERMITTE, F.; CAMBIER, J. & GAUTIER, J. C. - La méningo-encéphalite de la maladie de Behçet's: a propos d'une observation anatomo-clinique. Rev. Neurol. (Paris) 104:62, 1961.
2. AMOR, B. - Existe-t-il des arguments en faveur d'une origine immunologique ou allergique du syndrome de Behçet? Rev. Medicine (Paris) 36:2381, 1974.
3. BERLIN, C. - Behçet's disease as a multiple sympton complex. Arch. Dermatol. 83:128, 1960.
4. BISSON, M. - Les manifestations articulaires de la maladie de Behçet. Rev. Medicine (Paris) 35:2323, 1974.
5. BONNET, M. - Manifestations oculaires du syndrome de Behçet. Rev. Medicine (Paris) 35:2305, 1974.
6. BOUSSER, M. G. - Les manifestations neurologiques de la maladie de Behcet. Rev. Medicine (Paris) 35:2317, 1974.
7. CARR, G. R. - Cellulitis and thrombophlebitis in Behçet's syndrome. Lancet II:358, 1957.
8. CHAHADE, W. H.; FEDERICO, W. A. & ATRA, E. - A propósito de um caso de síndrome de Behçet. Rev. Paul. Med. (São Paulo) 73:131, 1968.
9. CHAJEK, T. & FAINARU, M. - Behçet's disease: report of 41 cases and a review of the literature. Medicine (Baltimore) 54:179, 1975.
10. CURTH, H. O. - Behçet's syndrome, abortive form: recurrent aphthous oral lesions and recurrent genital ulcerations. Arch. Dermatol. 54:481, 1946.
11. DEBRAY, Ch.; PAOLAGGI, J. A.; COUTURIER, D. & CRESPON, B. - Manifestations digestives de la maladie de Behçet. Rev. Medicine (Paris) 36:2367, 1974.
12. EVANS, A. D.; PALLIS, C. A. & SPILLANE, J. D. - Involvement of the nervous system in Behçet's syndrome: report of three cases and isolation of virus. Lancet 11:349, 1957.
13. GODEAU, P. - Manifestations cardiaques de la maladie de Behçet. Rev. Medicine (Paris) 36:2349, 1974.
14. HEWITT, A. B. - Behçet's disease: alleviation of bucal and genital ulceration by an oral contraceptive agent. British J. Vener. Dis. 47:52, 1971.1
15. MASON, R. M. & BARNES, C. G. - Behçet's syndrome with arthritis. Ann. Rheum. Dis. 28:95, 1969.
16. McMENEMEY, W. H. & LAWRENCE, B. J. - Encephalomyelopathy in Behçet's disease: report of necropsy findings in two cases. Lancet 11:353, 1957.
17. O'DUFFY, J. D.; CARNEY, J. A. & DEODHAR, S. - Behçet's disease: report of 10 cases, 3 with new manifestations. Ann. Intern. Med. 75:561, 1971.
18. O'DUFFY, J. D. - Criteres proposes pour le diagnostic de la maladie de Behçet et notes thérapeutiques. Rev. Medicine (Paris) 36:2371, 1974.
19. SOBEL, J. D. & HAIM, S. - Les thromboses et l'utilisation des fibrinolytiques dans la maladie de Behçet. Rev. Medicine (Paris) 36:2355, 1974.
20. SORS, H. - Manifestations pulmonaires du syndrome de Behçet. Rev. Medicine (Paris) 36:2359, 1974.
21. SCHWARTZ, M. N. & DODGE, P. E. - Bacterial meningitis: a review of selected aspects. New Engl. J. Med. 272:898, 1965.
22. TOURAINE, R. - Syndrome de Behçet: manifestations cutaneo-muqueuses. Rev. Medicine (Paris) 35:2299, 1974.
23. TOURAINE, R. - Le syndrome de Behçet: historique et nosologie. Rev. Medicine (Paris) 35:2293, 1974.

Datas de Publicação

Publicação nesta coleção
30 Ago 2012
Data do Fascículo
Jun 1977

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

[1] 1. ALAJOUANINE, Th.; CASTAIGNE, P.; LHERMITTE, F.; CAMBIER, J. & GAUTIER, J. C. - La méningo-encéphalite de la maladie de Behçet's: a propos d'une observation anatomo-clinique. Rev. Neurol. (Paris) 104:62, 1961.

[2] 2. AMOR, B. - Existe-t-il des arguments en faveur d'une origine immunologique ou allergique du syndrome de Behçet? Rev. Medicine (Paris) 36:2381, 1974.

[3] 3. BERLIN, C. - Behçet's disease as a multiple sympton complex. Arch. Dermatol. 83:128, 1960.

[4] 4. BISSON, M. - Les manifestations articulaires de la maladie de Behçet. Rev. Medicine (Paris) 35:2323, 1974.

[5] 5. BONNET, M. - Manifestations oculaires du syndrome de Behçet. Rev. Medicine (Paris) 35:2305, 1974.

[6] 6. BOUSSER, M. G. - Les manifestations neurologiques de la maladie de Behcet. Rev. Medicine (Paris) 35:2317, 1974.

[7] 7. CARR, G. R. - Cellulitis and thrombophlebitis in Behçet's syndrome. Lancet II:358, 1957.

[8] 8. CHAHADE, W. H.; FEDERICO, W. A. & ATRA, E. - A propósito de um caso de síndrome de Behçet. Rev. Paul. Med. (São Paulo) 73:131, 1968.

[9] 9. CHAJEK, T. & FAINARU, M. - Behçet's disease: report of 41 cases and a review of the literature. Medicine (Baltimore) 54:179, 1975.

[10] 10. CURTH, H. O. - Behçet's syndrome, abortive form: recurrent aphthous oral lesions and recurrent genital ulcerations. Arch. Dermatol. 54:481, 1946.

[11] 11. DEBRAY, Ch.; PAOLAGGI, J. A.; COUTURIER, D. & CRESPON, B. - Manifestations digestives de la maladie de Behçet. Rev. Medicine (Paris) 36:2367, 1974.

[12] 12. EVANS, A. D.; PALLIS, C. A. & SPILLANE, J. D. - Involvement of the nervous system in Behçet's syndrome: report of three cases and isolation of virus. Lancet 11:349, 1957.

[13] 13. GODEAU, P. - Manifestations cardiaques de la maladie de Behçet. Rev. Medicine (Paris) 36:2349, 1974.

[14] 14. HEWITT, A. B. - Behçet's disease: alleviation of bucal and genital ulceration by an oral contraceptive agent. British J. Vener. Dis. 47:52, 1971.1

[15] 15. MASON, R. M. & BARNES, C. G. - Behçet's syndrome with arthritis. Ann. Rheum. Dis. 28:95, 1969.

[16] 16. McMENEMEY, W. H. & LAWRENCE, B. J. - Encephalomyelopathy in Behçet's disease: report of necropsy findings in two cases. Lancet 11:353, 1957.

[17] 17. O'DUFFY, J. D.; CARNEY, J. A. & DEODHAR, S. - Behçet's disease: report of 10 cases, 3 with new manifestations. Ann. Intern. Med. 75:561, 1971.

[18] 18. O'DUFFY, J. D. - Criteres proposes pour le diagnostic de la maladie de Behçet et notes thérapeutiques. Rev. Medicine (Paris) 36:2371, 1974.

[19] 19. SOBEL, J. D. & HAIM, S. - Les thromboses et l'utilisation des fibrinolytiques dans la maladie de Behçet. Rev. Medicine (Paris) 36:2355, 1974.

[20] 20. SORS, H. - Manifestations pulmonaires du syndrome de Behçet. Rev. Medicine (Paris) 36:2359, 1974.

[21] 21. SCHWARTZ, M. N. & DODGE, P. E. - Bacterial meningitis: a review of selected aspects. New Engl. J. Med. 272:898, 1965.

[22] 22. TOURAINE, R. - Syndrome de Behçet: manifestations cutaneo-muqueuses. Rev. Medicine (Paris) 35:2299, 1974.

[23] 23. TOURAINE, R. - Le syndrome de Behçet: historique et nosologie. Rev. Medicine (Paris) 35:2293, 1974.