COULD IT BE BEHÇET'S DISEASE? PHYSICIANS IN PRIMARY HEALTHCARE ARE THE FIRST TO RESPOND

Abstract

Behçet's disease is a chronic relapsing vasculitis with complex immunopathogenesis that can affect multiple organs, although mucocutaneous lesions are predominantly observed. Diagnosis of Behçet's disease is challenging and relies on clinical manifestations as no specific laboratory test is available. A positive Pathergy test should raise suspicion of Behçet's disease. The authors present a clinical case of a 22-year-old woman who presented with intermittent fever, weight loss, odynophagia, dysphagia, left knee arthritis, and multiple painful oral-genital aphthosis. The patient received treatment with benzydamine hydrochloride mouthwash, lidocaine on ulcers, antibiotics, and non-steroidal anti-inflammatory drugs, but the healing process was slow, and a new disease attack occurred two months later. The Pathergy test was performed and found to be positive, prompting consultation with an immunologist and gynecologist. The patient was administered Colchicine (1.5 mg/day), which resulted in decreased symptoms, albeit with a slow healing process. During the 6-month follow-up period, the disease attack was followed by a period of remission. The evidence base for the treatment of Behçet's disease is limited, and current options include symptomatic, non-biological, and biological immunosuppressive drugs to reduce clinical manifestations. A thorough evaluation and education in primary healthcare settings are crucial to facilitate timely multidisciplinary referrals for effective management of Behçet's disease.