Behcet Disease and the Emergence of Thalidomide
Authors: George E. Ehrlich
Journal: Annals of Internal Medicine (1998)

Editorials15 March 1998Behcet Disease and the Emergence of ThalidomideGeorge E. Ehrlich, MDGeorge E. Ehrlich, MDUniversity of Pennsylvania; Philadelphia, PA 19106Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-128-6-199803150-00011 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail There may well be more articles about Behcet disease or syndrome in U.S. medical journals than there are patients with true Behcet disease in the United States. The international criteria for diagnosis [1] are recurrences of oral ulcerations plus two of the following: recurrent genital ulcers, skin lesions, eye lesions, and a positive result on a pathergy test. The seeming blandness and all-inclusiveness of these criteria lead to overdiagnosis because patients with other mucocutaneous diseases, such as ulcerative colitis, regional enteritis, the Reiter syndrome and other reactive arthropathies, the Stevens-Johnson syndrome, and systemic lupus erythematosus, might qualify [2].Most true ...References1. Criteria for diagnosis of Behcet's disease. International Study Group for Behcet's Disease. Lancet. 1990; 335:1078-80. Google Scholar2. Yazici H. The place of Behcet's syndrome among the autoimmune diseases. Int Rev Immunol. 1997; 14:1-10. Google Scholar3. Sakane T. New perspective on Behcet's disease. Int Rev Immunol. 1997; 14:89-96. Google Scholar4. Dilsen N. History and development of Behcet's disease. Rev Rhum Engl Ed. 1996; 63:512-9. Google Scholar5. Ehrlich GE. Vasculitis in Behcet's disease. Int Rev Immunol. 1997; 14:81-8. Google Scholar6. Ehrlich GE. Behcet's disease or Behcet's syndrome: does it make a difference? Brazilian Journal of Rheumatology. 1994; 34:220-2. Google Scholar7. Lehner T. The role of heat shock protein, microbial and autoimmune agents in the aetiology of Behcet's disease. Int Rev Immunol. 1997; 14:21-32. Google Scholar8. Yamakawa Y, Sugita Y, Takahashi Y, Yamakawa T, Tanaka S, Nakamura S, et al. Gene expression of tumour necrosis factor-α (TNF-α) and heat-shock protein (HSP) 70 in patients with Behcet's disease. Arch Dermatol Res. 1993; 285:505-8. Google Scholar9. Nakae K, Masaki F, Hashimoto T, Inaba G, Mochizuki M, Sakane T. Recent epidemiological features of Behcet's disease in Japan. In: Wechsler B, Godeau P, eds. Behcet's Disease. Amsterdam: Excerpta Medica; 1993. Google Scholar10. Heymann RE, Ferraz MB, Quaresma MR, Golcalves CR, Atra E. The role of ambiental agents in Behcet's disease. Rev Rhum Engl Ed. 1995; 62:343-8. Google Scholar11. Shimizu T, Ehrlich GE, Inaba G, Hayashi K. Behcet's disease (Behcet's syndrome). Sem Arthritis Rheum. 1979; 8:223-60. Google Scholar12. Yamashita N. Hyperreactivity of neutrophils and abnormal T cell homeostasis: a new insight for pathogenesis of Behcet's disease. Int Rev Immunol. 1997; 14:11-20. Google Scholar13. Prchal JT, Blakeley J. Granulocyte platelet rosettes [Letter]. N Engl J Med. 1973; 289:1146. Google Scholar14. Ehrlich GE, Kajani M, Schwartz IR, McAlack RF. Further studies of platelet rosettes around granulocytes in Behcet's syndrome. Inflammation. 1975-6; 1:223-9. Google Scholar15. Torras H, Lecha M, Mascaro JM. Thalidomide treatment of recurrent necrotic giant mucocutaneous aphthae and aphthosis [Letter]. Arch Dermatol. 1982; 118:875. Google Scholar16. Jacobson JM, Greenspan J, Spritzler J, Ketter N, Fahey JL, Jackson JB, et al. Thalidomide for the treatment of oral aphthous ulcers in patients with human immunodeficiency virus infection. National Institute of Allergy and Infectious Diseases AIDS Clinical Trials Group. N Engl J Med. 1997; 336:1487-93. Google Scholar17. Reyes-Teran G, Sierra-Madero JG, Martinez del Cerro V, Arroyo-Figueroa H, Pasquetti A, Calva JJ, et al. Effects of thalidomide on HIV-associated wasting syndrome: a randomized, double-blind, placebo-controlled clinical trial. AIDS. 1996; 10:1501-7. Google Scholar18. Hamuryudan V, Mat C, Saip S, Ozyazgan Y, Siva A, Yurdakul S, et al. Thalidomide in the treatment of the mucocutaneous lesions of the Behcet syndrome. A randomized, double-blind, placebo-controlled trial. Ann Intern Med. 1998; 128:443-50. Google Scholar19. Tseng S, Pak G, Washenik K, Pomeranz MK, Shupack JL. Rediscovering thalidomide: a review of its mechanism of action, side effects, and potential uses. J Am Acad Dermatol. 1996; 35:969-74. Google Scholar Author, Article, and Disclosure InformationAuthors: George E. Ehrlich, MDAffiliations: University of Pennsylvania; Philadelphia, PA 19106Current Author Address: George Ehrlich, MD, One Independence Place #1101, 241 South Sixth Street, Philadelphia, PA 19106. 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