Infliximab monotherapy in neuro-Behçet's disease: four year follow-up in a long-standing case resistant to conventional therapies

Behçet's disease (BD) is a vasculitis characterized by hallmark lesions of oral and genital ulcers (Krause andWeinberger, 2008). Involvement of parenchymal central nervous system (neuro-BD) is a serious complication commonly characterized by brainstem and/or basal ganglia lesions (Al- Araji and Kidd, 2009). To date, the treatment of neuro-BD remains largely empirical, andmay not adequately control the disease (Al-Araji and Kidd, 2009). Given the well-recognized role played by tumor necrosis factor-α (TNFα) in the pathogenesis of active BD (Santos Lacomba et al., 2001), infliximab (a monoclonal antibody that binds to and neutralizes the activity of TNFα) has been adopted with favorable results in patients resistant to conventional immunosuppressive therapies and in a small placebo controlled study (Goossens et al., 2001; Arida et al., 2010).