Refractory Behçet's disease treated with low-dose interleukin-2: A case report

Medicine (Baltimore). 2022 Oct 21;101(42):e31173. doi: 10.1097/MD.0000000000031173.

Abstract

Rationale: Behçet's disease (BD) is an autoimmune disease presented with recurrent oral aphthous ulcers, genital ulcers, uveitis and skin lesions. The cutaneous manifestations are often refractory and more resistant to conventional therapy. This report provides a new treatment of low-dose interleukin-2 (IL-2) with refractory BD patient.

Patient concerns: A 37-year-old female patient experienced oral ulcer and erythema nodosum on the right leg for over 12 months and resisted to Methylprednisolone and Thalidomide.

Diagnoses: The patient suffered from recurrent painful oral ulceration and an erythema nodosum. Pathergy test is also positive. Thus, we diagnosed her as BD according to the International Criteria for Behçet's Disease (ICBD).

Interventions: The patient took Methylprednisolone 8 mg qd, Thalidomide 50 mg qn and Hydroxychloroquine 200 mg bid successively as treatment. However, the medicine didn't take effect. Finally, this patient was given low-dose IL-2 intramuscular injection qod for 3 months.

Outcomes: Oral ulcers and the erythema disappeared and the patient has been symptom-free for 6 months.

Lessons: low-dose IL-2 is a safe and effective treatment for refractory BD.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Behcet Syndrome* / complications
  • Behcet Syndrome* / diagnosis
  • Behcet Syndrome* / drug therapy
  • Erythema Nodosum*
  • Female
  • Humans
  • Hydroxychloroquine / therapeutic use
  • Interleukin-2 / therapeutic use
  • Methylprednisolone / therapeutic use
  • Oral Ulcer* / drug therapy
  • Oral Ulcer* / etiology
  • Thalidomide / therapeutic use

Substances

  • Interleukin-2
  • Thalidomide
  • Hydroxychloroquine
  • Methylprednisolone