Rinsho Shinkeigaku (Clinical Neurology)

Case Report

A case of neuro-Behçet's disease triggered by herpes zoster-associated uveitis

Naoki Okamoto, M.D.1), Nobuhiro Ogawa, M.D., Ph.D.1), Akihiro Kitamura, M.D., Ph.D.1), Isamu Yamakawa, M.D., Ph.D.1), Hyoh Kim, M.D., Ph.D.1) and Makoto Urushitani, M.D., Ph.D.1)

1) Department of Neurology, Shiga University of Medical Science

A 69-year-old man was admitted for persistent fever, arthralgia, and visual impairment. Physical examination demonstrated bilateral uveitis and recurrent aphthous stomatitis. The PCR analysis of the aqueous humor of the anterior chamber was positive for the Varicella-zoster virus (VZV). Although no neurological defect was evident, the cerebrospinal fluid contained elevated monocytes but was negative for VZV-PCR. Brain MRI revealed Gd-enhanced lesions in the subcortical white matter, basal ganglia, and cerebellum. With his positive HLAB51, he was diagnosed with neuro-Behcet's disease (NBD) and was successfully treated with high-dose prednisolone. Although the pathogenesis of Behcet's disease is still unknown, the involvement of viral infection is reported. The present case implies that NBD could be triggered by herpes zoster virus associate-uveitis; the accumulation of such cases would help clarify the pathogenesis of Behcet's disease.
Full Text of this Article in Japanese PDF (2562K)

(CLINICA NEUROL, 61: 640−645, 2021)
key words: varicella-zoster virus, neuro-Behçet's disease, bilateral uveitis, recurrent aphthous stomatitis

(Received: 2-Apr-21)