1. Consorcio Sanitario de Terrassa
Behçet disease with low response to several biological treatments, 4 years folow up
Suhel Elnayef
Barbara Delás
Mouafk Asaad
Consorcio Sanitario de Terrassa

2. Clinical Case
A 28 years old male, from Morocco, attended our hospital for left eye pain, red eye and blurred vision with retroorbital headache without fever.
- panuveitis on his right eye
- oral and genital ulcers
- knee arthritis
Uncorrected VA: NLP / HM
BMC:
Right eye: cyclitic membrane.
Left eye: keratic precipitates, tyndal ++, flare +++, remains of cyclitic membrane on crystalline and hematic color masses beyind cristalline.

3. Treatment Treatment : Anti-inflammatory and topical mydriatic.
Internal medicina treatment: Prednisolona 90mg/día sistémica, ciclosporina 100mg/12h, colchicina 1mg/d.
3 m after : VA Left Eye 0.1 (20/200).
Partial resolution of synechiae, vitreous moderate fibrosis.
Development of posterior subcapsular cataract , so operation was performed

4. Macular Edema after cataract surgery
6 m after IQ:
VA LE 0.1 (20/100)
OCT: Cystoid macular edema 557 µm
Plan: Triamcinolone IV injection

5. Several outbreaks of CME in the folowing year

6. Starting Infliximab 5mg/kg (10 dose in 1 year)
2 Outbreaks in 1 year

7. Starting Adalimumab 80 mg per month (1 year)
2 Outbreaks in 1 year

8. Starting tocilizumab 162 mg per week (1 year)
2 Outbreaks in 1 year

9. Starting Anakinra 100 mg/day (1 year)
2 Outbreaks in 1 year

10. Conclusions
We noticed that the number of CMA outbreaks has decreased since begining of infliximab therapy
The patient still have recurrent posterior uveitis (2 outbreaks per year)
Changing biological therapy (infliximab, adalimumab, tocilizumab and anakinra) has not produced a decrease in the number of recurrences