Central nervous system symptoms in patients with Behçet disease receiving cyclosporine therapy

Abstract

ObjectiveTo investigate the association between the development of central nervous system (CNS) symptoms in patients with Behçet disease and medical therapy. DesignRetrospective cohort study. ParticipantsA total of 317 patients with Behçet disease with ocular complications who visited Hokkaido University Hospital, Sapporo, Japan, between 1978 and 1994. Main outcome measuresThe incidence of CNS symptoms in different medical therapies. ResultsTwenty-one (6.6%) of the 317 patients developed CNS symptoms, namely neuro-Behçet disease. Of the 21 patients, 12 were undergoing cyclosporine therapy. Of the 47 patients who underwent cyclosporine therapy, 12 (25.5%) developed CNS symptoms, whereas only 9 (3.3%) of 270 patients who did not undergo cyclosporine therapy developed CNS symptoms. ConclusionsCyclosporine in the treatment of Behçet disease appears to cause neurotoxicity or to accelerate the development of CNS symptoms. Thus, neurologic complications appear to represent a major side effect of cyclosporine in the treatment of patients with Behçet disease.