Handouts (Heft) - Rheuma Schweiz
Handouts (Heft) - Rheuma Schweiz
Handouts (Heft) - Rheuma Schweiz
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15.08.2013<br />
SS and MS-like lesion<br />
Behçet disease<br />
5-30% of pts with BD have neurologic complications<br />
• MS-like syndromes (optic neuritis, neuromyelitis optica, brainstem)<br />
• sinus venous thrombosis, stroke<br />
• menigitis, encephalitis<br />
• cranial neuropathies<br />
• polyneuropathy<br />
D: clinical picture, HLA-B51<br />
P.D., 49y<br />
Th: steroids, azathioprine/methotrexate, cyclophosphamide<br />
Lancet 2005; 365: 1046-53<br />
Haghighi, The Neurologist NEJM 2005; Hirohata, 2005; 353: J 2034-41 Neurol Sci 2008; Penho, Eur J Neurol 2012<br />
Neurobehçet<br />
Wegener granulomatosis<br />
30-50% of patients with neurologic complications<br />
• cranial neuropathies (II, VI, VII, VIII)<br />
• mononeuritis multiplex, polyneuropathy<br />
• stroke<br />
• myelitis<br />
• meningitis, encephalitis<br />
• seizures<br />
D: clinical picture, C-ANCA, biopsy<br />
Th: steroids, cyclophosphamide<br />
Lancet 2005; 365: 1046-53<br />
Haghighi, The Neurologist 2005<br />
Nishino, Ann Neurol 1993<br />
NEJM 2005; 353: 2034-41<br />
Polyarteritis nodosa (PAN)<br />
<strong>Rheuma</strong>toid arthritis (RA)<br />
25-50% of PAN pts have neurologic complications<br />
• stroke (ischemic/hemorrhagic)<br />
• encephalopathy<br />
• cranial neuropathies (III, IV, VI, VIII)<br />
• mononeuritis multiplex, polyneuropathy, myalgias<br />
• myelitis<br />
D: clinical picture, + hepatitis serology, biopsy<br />
Th: steroids, cyclophosphamide (azathioprine, IVIG, PE,<br />
mycophenolate mofetil, rituximab)<br />
Lancet 2005; 365: 1046-53<br />
1-5% of RA pts have neurologic complications<br />
• myelopathy (atlanto-axial subluxation)<br />
• stroke<br />
• polyneuropathy, mononeuritis multiplex, polymyositis<br />
D: clinical picture, + hepatitis serology, biopsy<br />
Th: steroids, methotrexate, azathioprine<br />
(cyclophosphamide, IVIG, ...)<br />
Lancet 2005; 365: 1046-53<br />
NEJM 2005; 353: 2034-41<br />
NEJM 2005; 353: 2034-41<br />
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