Behçet's disease

Many people may not know about Behcet's disease, which is a very rare immune system disease. It is named after the doctor who discovered it, Behcet. After suffering from Behcet's disease, it will cause serious damage to the patient's skin, mucous membranes, visual system, etc., which is very harmful. Next, let’s look at the treatment of Behcet’s disease.

Medication

The local area of the eye is treated as usual for uveitis. Topical administration of glucocorticoids, such as 0.5% dexamethasone eye drops, can be applied frequently to the eyes, and eye ointment can be used before bedtime. Oral administration is preferred for systemic administration, and intravenous administration should be avoided as much as possible. In principle, large doses should be used for a short period of time, and the dosage should be gradually reduced after relief. Combined use with immunosuppressive drugs can not only enhance the therapeutic effect, but also reduce their respective dosages and side effects.

Opinions vary regarding the choice of immunosuppressive drugs. Among alkylating immunosuppressive drugs such as cyclophosphamide, azathioprine, and chlorambucil, chlorambucil has the best efficacy. The initial daily dose is 0.1-0.15 mg/(kg·d) and continued for 5-6 months, or gradually reduced after the inflammation is controlled for 3-4 months, and finally reduced to a maintenance dose of 2 mg/d. The entire course of treatment lasts more than 1 year. Blood counts should be checked regularly during medication. If the total white blood cell count decreases sharply, or adverse reactions such as optic disc edema, retinal hemorrhage, etc. occur in the fundus, the drug should be discontinued. In addition, tumors may cause infertility, so the consent of the patient and his or her family should be obtained before using the medication. It is contraindicated in patients with impaired renal function. Japanese scholars have a high opinion of cyclosporine, and the reduction in severe cases is related to the widespread use of cyclosporine. However, attention must also be paid to its toxic side effects. It is contraindicated in patients with poor liver and kidney function, hypertension that cannot be controlled by antihypertensive drugs, and pregnant women. In addition, cyclosporine A can easily cause damage to the nervous system, so it is not suitable for patients with neurological Behcet's disease or a history of neuropsychiatric illness. The immunomodulatory drug levamisole has its own characteristics for oral mucosal ulcers, leukocyte chemokine inhibitors, and colchicine has its own characteristics for skin nodular erythema. It can be used as an option for patients with lesions other than these eyes. The pathological basis of multi-organ damage in Behcet's disease is perivascular inflammation and endovascular inflammation. Laboratory examinations showed decreased fibrinolytic activity, hypercoagulation, increased immune complexes in the blood, and choroidal and retinal vein occlusions. Therefore, plasminogen activators, platelet aggregation inhibitors, etc. are given according to the condition; when ineffective, plasma exchange therapy can be tried.

Diet and health care

It is better to eat light meals, small meals frequently, with a variety of choices, high-calorie, high-protein, high-vitamin, easily digestible, residue-free liquid diet, and eat less spicy and irritating foods. During the oral ulcer period, liquid diet such as milk, broth, etc. should be given, and hard, overheated and irritating food should be avoided to prevent damage or aggravation of oral ulcers and cause pain. Patients should be encouraged to eat small amounts slowly to increase nutrition, strengthen physical fitness and promote recovery.

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