A case report on dramatic response of refractory panuveitis of Behcet disease to short-term therapy with Infliximab followed by Cellcept

Behcet disease (BD) is a multisystem vasculitic syndrome with clinical triad of oral aphthus ulcer,genital ulcer, and eye involvement. Uveitis of BD may be particularly resistant to corticosteroids andimmunosuppressants with a rapid progression to loss of vision in 10-25% of the cases. In recent years,Infliximab is a very useful drug for refractory eye involvement of BD and some studies recommendCellcept for this reason.Here, we reported a 40 years old man with known BD, referred to our Clinic with severe bilateralpanuveitis. His eye involvement was refractory to conventional therapy in 15 months follow-up; thenhe was switched to Infliximab, in an attempt to control his disease. Infliximab (3mg/kg) was given at0, 4, 8 weeks (three doses) together with Azathioprin. Very soon after the first infusion, we have founda remarkable ophthalmologic response. We have prescribed Cellcept after the third infusion anddiscontinued Azathioprin and Infliximab.14 months after the last infusion, no significant changes werefound in ophthalmologic examination. Our observation highlights a difference in the effect of Cellceptin panuveitis of BD.