[Immunosuppressors in Behçet's disease].

Immunosuppressive therapy in Beh^et's disease Immunosuppressive therapy seetm to he the treatment ofchoice in Beh<;et's disease if administered early, at adequate dosages andfor relatively long periods of time. Corticosteroids can be very effective durlng the initial stages ofthe disease, but the frequeni and rapid onset of dependence and resistance to these drugs limits their usefulness. The Authors report a case ofBehget's disease treated with the immunosuppressive alkylating agent chlorambucil. Thepatient, a 39year old white male, presented the followingclinicaland laboratory findings: aphthae buccalis andgenitalis, diffused uveitis with marked retinal vasculitis, pyoderma, diffused arthralgia, relapsis hydrarthrosis, HLA B5 marker, circidating immimocomplexes and increased serum C4. Chlorambucil was initially administered in a single 5 mg daily dose, after 3 months of corticosteroid (prednisone) treatment. The dosage of chlorambucil was itureased by 2.5 mg/week imtil a dady dose of 12.5 mg was reached. MeanwhUe, corticosteroid treatment was withdrawn. After 5 months of treatment, there was complete remission ofeye inflammation as well as remarkable general improvement. Dosages of chlorambucd were progressively decreased over the next 7 months. C4 serum levels returned to norrnal. Relapses of eye inflammation were sporadic and mild and appeared more amenable to corticosteroid treatment. These results confirm the previous observation of5I patients after early administration of chlorambucd: overall improvement of their clinical condition and prognosis of Behget's disease was demonstrated. Key words: Behget's disease, chlorambucil, immunosuppressive drugs, uveitis.