Neuro-Behçet Disease Manifesting as Multiple Cerebral Aneurysms

Abstract

A 69-year-old man was brought to the emergency department due to an acute onset of fever, altered mental status, and left motor deficit. Brain MRI disclosed bilateral acute and subacute strokes (figure, B). CSF identified aseptic meningitis. Extensive infectious workup was unremarkable. Cerebral angiography revealed more than 20 intracranial aneurysms, some fusiform (figure , A). Neuro-Behçet disease (NBD) was confirmed due to history of oral ulcers, positive pathergy test, and HLA-B51. Steroids were started with clinical response. NBD is very rarely associated with cerebral aneurysms, caused by obliterative endarteritis of the vaso vasorum. 1,2 Multiple aneurysms and fever with no infectious cause should prompt investigation for NBD.

Metabolic alterations of peripheral blood immune cells and heterogeneity of neutrophil in intracranial aneurysms patients

“…4,5 However, recent studies have highlighted the crucial role played by the peripheral immune environment in these mechanisms. 6,7 Chronic inflammation, such as periodontitis, might exert sustained disturbances on the peripheral immune environment, potentially altering the pro-inflammatory activity of specific peripheral blood mononuclear cells (PBMCs) and impacting the formation of IAs. 8 Relevant high-dimensional peripheral blood analyses have indicated disproportions and immune activation phenomena in T cells, monocytes and B cells within the peripheral blood of aneurysm patients.…”

“…The disruption of the local immune microenvironment, characterised by the infiltration of lymphocytes and macrophages, is commonly considered a significant mechanism in the formation and development of IAs 4,5 . However, recent studies have highlighted the crucial role played by the peripheral immune environment in these mechanisms 6,7 …”

“… 4 , 5 However, recent studies have highlighted the crucial role played by the peripheral immune environment in these mechanisms. 6 , 7 …”