高龄起病白塞病2例——附文献复习

Two cases of elderly onset Behcet's disease and literature review

目的白塞病(Behcet's disease,BD)是一种多系统累及的血管炎病,罕见,中老年发病(>50岁)。方法分析2例80岁以上高龄老年起病BD患者的临床资料,并进行相关文献复习。结果患者均为男性,发病年龄82岁和88岁,以口腔阿弗他溃疡、生殖器溃疡、皮肤病变为临床表现。分别给予秋水仙碱或依那西普治疗联合小剂量沙利度胺。由于2例患者分别出现严重恶心、呕吐、腹泻和感染发热,停用秋水仙碱和依那西普治疗。改用小剂量沙利度胺和局部加用GM-CSF治疗。2周后,患者皮肤黏膜病变愈合,且无不良反应。结论小剂量沙利度胺联合局部GM-CSF治疗对老年皮肤黏膜型BD安全有效。

Objective Behcet's disease(BD) is a multisystem disorder characterized by vasculitis.Patients with late onset BD(age of onset at or after 50 years) are very rare.Methods Two patient of advanced age(> 80 years old)with late onset BD was reported and the related literatures were reviewed.Results We describe two male patients presented with oral aphthous ulcers,genital ulcers and skin lesions.They were treated with colchicine and etanercept,respectively,combined with thalidomide.Due to severe gastrointestinal complaints,such as nausea,vomiting and diarrhea,colchicine was stopped after 2 weeks.Another patient with common cold high and fever discontinued etanercept.Additionally they received topical granulocyte macrophage colony-stimulating factor(GM-CSF) and mucocutaneous lesions resolved after 2weeks without adverse event.Conclusion Low dose of thalidomide combined with locally applied GM-CSF may be safe and effective for patient with late onset mucocutaneous BD.