Debut de la enfermedad de behçet como meningoencefalitis y amaurosis súbita
2002
espanolCaso clinico Paciente varon de 41 anos debuta con cuadro de meningoencefalitis linfocitaria y perdida visual bilateral, ademas de trombosis del seno transverso, iniciandose tratamiento mediante prednisona y anticoagulacion. A nivel retiniano se aprecio una arteritis oclusiva, signos de periflebitis, isquemia periferica y falta de perfusion macular en ambos ojos. El cuadro fue sugerente de enfermedad de Behcet anadiendose Azatioprina a la terapeutica sistemica sin objetivarse mejoria visual. Cuatro meses mas tarde el paciente desarrollo aftas orales lo que ayudo a confirmar el diagnostico. Discusion La enfermedad de Behcet puede debutar con perdida subita de la vision secundaria a una oclusion arteritica retiniana masiva. El estado critico del debut como neuro-Behcet puede hacer retrasar el diagnostico. Esta asociacion conlleva un mal pronostico visual. EnglishCase report A 41-year-old man presented a clinical picture characterized by lymphocytic meningoencephalitis, visual loss in both eyes and transverse sinus thrombosis. This picture was treated with prednisone and anticoagulation. Fundus examination showed complete occlusive arteritis, periphlebitis, peripheral ischemia and perfusion macular defects affecting both eyes. The picture was suggestive of Behcet's disease. Azathioprine was added to the treatment without improvement in visual acuity. Four months later oral aphtous ulcers developed, confirming the suspected diagnosis. Discussion Behcet's disease may appear with the sudden onset of visual loss secondary to massive occlusive retinal vasculitis. The critical state of neuro-Behcet disease may delay the diagnosis. This combination of visual and neurological symptoms is associated with a poor visual prognosis (Arch Soc Esp Oftalmol 2002; 77: 275-278). Key words
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