A rare case of Behçet's syndrome presenting with bilateral papillitis

A previously healthy 28-year-old white man complained of acute headache and mildly blurred vision since a month earlier which did not respond to analgesics. Brain magnetic resonance imaging was normal. He did not agree to be admitted and nor to additional testing by a neurologist and did not respond to oral acetazolamide. At the next visit (a month later), the ophthalmic examination showed the best corrective vision of 7/10 in both eyes, and 2 + cell in the right eye anterior chamber. Except for leukocytosis and positive C reactive protein, other tests (including cerebrospinal pressure and composition and brain magnetic resonance angiography) were normal. The rheumathologist consultation revealed a history of Behçet in the patient and his brother and HLA B5 was positive. Optic disc swelling significantly decreased with interavenous stroid and the headache disappeared. Two weeks later, visual acuity reached 9/10 and papillitis resolved.