Co-Occurrence of Behçet's Disease and Ankylosing Spondylitis: A Rare Case Report
Abstract
Introduction
Behçet's Disease and Ankylosing Spondylitis are two distinct inflammatory conditions that have rarely been reported to coexist. This study reports a 41-year-old male patient with the co-occurrence of both conditions.
Case presentation
A 41-year-old male presented with chronic lower back pain for a period of 20 years. He also had left eye redness and painful oral ulcers. On physical examination, there were oral lesions and left eye redness (uveitis), and the patient's spine exhibited restricted mobility. Magnetic Resonance Imaging of the sacroiliac joint showed sacroiliacis affecting both sacroiliac joints. Hence, the patient was diagnosed as a case of mixed Behcet's disease and ankylosing spondylitis. The patient was managed with Azathioprine (Imuran) tablet (50 mg) twice daily, Colchicine tablet (1 mg) once daily, Topical steroid and Ulciguard mouth spray, Prednisolone tablet (5 mg) once daily, calcium and vitamin D3 tablet once daily, steroid eye drops, nonsteroidal anti-inflammatory drugs for 2 weeks. As a result, the patient achieved a dramatic response with all the symptoms resolved.
Conclusion
Behçet's disease and ankylosing spondylitis can coexist with overlapping presentations, making their clinical diagnosis challenging.
References
- Chang HK, Cho EH, Kim JU, Herr H. A case of coexisting Behcet’s disease and ankylosing spondylitis. The Korean Journal of Internal Medicine. 2000;15(1):93. doi:10.3904/kjim.2000.15.1.93
- Shorsh A. Mohammed, Fahmi H. Kakamad, Soran H. Tahir, Marwan N. Hassan, Miran Najmadden Hassan, Berun A. Abdalla, et al. May-Thurner syndrome as the presenting symptom of Behcet’s disease; a rare case report. Barw Medical Journal, 1(1). doi:10.58742/bmj.v1i1.17
- Tahira SH, Kakamad FH, Hussein DM, Mohammed SA, Rshid RJ, Salih KM, et al. Behcet’s disease presenting with focal fibrosing mediastinitis and cava thrombosis; a case report with a review of the literature. Barw Medical Journal. 2023;1(2). DOI: N/A
- Habibagahi M, Habibagahi Z, Saidmardani SM, Sadeghian F. No definite association between human parvovirus B19 infection and Behcet disease. Iranian journal of medical sciences. 2015;40(6):493. DOI: N/A
- Aktas Cetin E, Cosan F, Kucuksezer UC, Bilgic S, Cagatay Y, Gul A, et al. Behçet’s disease: immunological relevance with arthritis of ankylosing spondylitis. Rheumatology international. 2013; 33:733-41. doi:10.1007/s00296-012-2446-9
- Aso S. Muhialdeen, Jaafar Omer Ahmed, Hiwa O. Baba, Ismael Y. Abdullah, Hemn Ali Hassan, Kayhan A. Najar, et al. Kscien’s List; A New Strategy to Discourage Predatory Journals and Publishers (Second Version). Barw Medical Journal. 2023;1(1). doi:10.58742/bmj.v1i1.14.
- Krause I, Yankevich A, Fraser A, Rosner I, Mader R, Zisman D, et al. Prevalence and clinical aspects of Behcet’s disease in the north of Israel. Clinical rheumatology. 2007; 26:555-60. doi:10.1007/s10067-006-0349-4
- Dean LE, Jones GT, MacDonald AG, Downham C, Sturrock RD, Macfarlane GJ. Global prevalence of ankylosing spondylitis. Rheumatology. 2014;53(4):650-7. doi:10.1093/rheumatology/ket387
- Eser F, Bodur H, Seçkin Ü. Coexistence of Behçet's disease and ankylosing spondylitis: A case report. Archives of Rheumatology. 2008;23(2):069-71. DOI: N/A
- Olivieri IG, Gemignani GA, Busoni FR, Pecori FA, Camerini EM, Trippi DO, et al. Ankylosing spondylitis with predominant involvement of the cervical spine in a woman with Behçet's syndrome. Annals of the rheumatic diseases. 1988;47(9):780-3. doi:10.1136/ard.47.9.780
- Yazici Y, Hatemi G, Bodaghi B, Cheon JH, Suzuki N, Ambrose N, et al. Behçet syndrome. Nature Reviews Disease Primers. 2021;7(1):67. doi:10.1038/s41572-021-00301-1
- Demirkesen C, Tüzüner N, Mat C, Senocak M, Büyükbabani N, Tüzün Y, et al. Clinicopathologic evaluation of nodular cutaneous lesions of Behçet syndrome. American journal of clinical pathology. 2001;116(3):341-6. doi:10.1309/GCTH-0060-55K8-XCTT
- Zhu W, He X, Cheng K, Zhang L, Chen D, Wang X, et al. Ankylosing spondylitis: etiology, pathogenesis, and treatments. Bone research. 2019;7(1):22. doi:10.1038/s41413-019-0057-8
- Celik C, Halil UÇ, UÇKUN AÇ, ALEMDAROĞLU E. Coexistence of Behçet's disease and ankylosing spondylitis. Archives of Rheumatology. 2011;26(3):271-2. doi:10.5606/tjr.2011.045
- Koçyiğit H, Turan Y, Bayram K, Gurgan A, Deveci H, Güvenç A. Coexistence of behçet's disease and ankylosing spondylitis: a case report. Archives of Rheumatology. 2010;25(4):217-20. doi:10.5152/tjr.2010.32
- Akassou A, Bakri Y. Does HLA-B27 status influence ankylosing spondylitis phenotype?. Clinical Medicine Insights: Arthritis and Musculoskeletal Disorders. 2018; 11:1179544117751627. doi:10.1177/1179544117751627
- Burillo-Sanz S, Montes-Cano MA, García-Lozano JR, Olivas-Martínez I, Ortego-Centeno N, García-Hernández FJ, et al. Behçet’s disease and genetic interactions between HLA-B* 51 and variants in genes of autoinflammatory syndromes. Scientific Reports. 2019 Feb 26;9(1):2777. doi:10.1038/s41598-019-39113-5
- Kardeş SI, Karagülle MI, Karagülle MZ, ERDOĞAN N. Coexistence of Behçet’s disease and ankylosing spondylitis: Case report and review of the literature. Acta Med Mediterr. 2016; 32:947. doi:10.19193/0393-6384_2016_4_114
- Alibaz-Oner F, Direskeneli H. Advances in the Treatment of Behcet’s Disease. Current rheumatology reports. 2021;23(6):47. doi:10.1007/s11926-021-01011-z
- Fan M, Liu J, Zhao B, Wu X, Li X, Gu J. Indirect comparison of NSAIDs for ankylosing spondylitis: Network meta‑analysis of randomized, double‑blinded, controlled trials. Experimental and Therapeutic Medicine. 2020;19(4):3031-41. doi:10.3892/etm.2020.8564
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