Behcet disease combined with Sjogren syndrome

Abstract

Rationale:Behcet disease(BD) and Sjogren syndrome(SS) are separate conditions that rarely concomitantly affect an individual. In theory,mild symptoms of patients with BD or SS are easy to igore and,thus,remain undiagnosed. There,it is reasonable to believe there may be some clinical cases of combined diseases that go undiscovered and which needs to be taken seriously. In addition,it has been suggested that herpes simplex virus(HSV) types 1 and 2 are associated with BD,but have not been shown to be correlated to the direct pathogenesis of BD. The role of HSV in BD needs more research and attention.Patient concerns:Here,we report a young woman who had both BD and SS. The first symptom of the disease was fever. However,the HSV type 1 IgG and HSV type 2 IgM antibody results were positive in our case and,which rendered this case unique.Diagnoses:BD and SS concomitantly affect the individual,and BD was the acute type.Interventions:IV methylprednisolone was used for 9 days and then oral glucocorticoids was used to instead,and the treatment works very well.Outcomes: BD and SS can concomitantly affect an individual,and we believe that HSV-2 may be directly related to the pathogenesis of BD. The nature of BD as an auto-inflammatory disorder, autoimmune disorder, or both, is controversial. If we can find more patients who combined affected these two disease, it might helpful for us to understand the nature of BD.Lessons:For patients with clinical diagnosis of BD or SS,we need to be alert that it may combinded the other disease. Long term follow up and detailed inspection are important means to avoid undiscovered.

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“…[1][2][3] The literature in Pubmed was reviewed using controlled terms from the Virtual Health Library and Decs/Mesh and with the use of Boolean operators: Sjögren's Syndrome / Sjogren's Syndrome / Sjogren's Syndrome AND Behçet's Syndrome / Behcet Syndrome / Behçet's Syndrome, obtaining few reports. [4][5][6][7] In the reported case, the first diagnosis, maintained for years, was Sjogren's syndrome (SS), with periodic rheumatological and ophthalmological controls. In SS, the appearance of oral ulcers is possible given the dryness of the mucous membranes, friction with the teeth and the alteration of the usual oral flora, which predisposes to thrush and superinfections, situations that overlapped the diagnosis of BS for many years, added to the fact that no ocular lesions suggestive of BS appeared.…”

Using hierarchical similarity to examine the genetics of Behçet’s disease

“…The results of our CFG approach have the benefit of identifying autoimmune diseases with a shared genetic architecture to BD. The inclusion of certain diseases in the 16 identified diseases was expected: Uveitis is symptom of BD [ 32 ], Sjögren’s Syndrome often presents with but is not associated with BD [ 33 – 35 ], and Crohn’s disease presents with similar symptoms to IBD [ 36 ].…”