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[Immunosuppressive agents and Behçet's syndrome: critical analysis of results]
12 patients suffering from Behçet's disease have received immunosuppressive therapy. All patients have been given chlorambucil. In addition 5 patients who were threatened by an acute and permanent blindness from severe retinal vein involvement received antilymphocyte globulins. The follow-up ranges from 1 year up to 71/2 years with an average of 31/2 years. Complete recovery from ocular inflammation has been achieved in all patients. Visual acuity remained unchanged or improved in all patients but 1. Ocular recurrences occurred in 2 patients after decreasing the daily dose of chlorambucil and in 1 patient 2 years after the end of a 1-year treatment. The action of chlorambucil was not so constant upon systemic involvement of the disease than upon ocular inflammation. Nevertheless, 1 patient recovered from severe central nervous system involvement with hemiplegia. The review of the literature and comparison with our own experience leads to suggest that the discrepancy of the published results should be related to the variety of the immunosuppressive drugs which have been tried in Behçet's disease. Chlorambucil seems to be the most effective and the less toxic drug. But its action upon eye inflammation requires 2-3 months to take place. Therefore, in the most severe cases threatened by an acute and permanent blindness, the treatment should be started with antilymphocyte globulins.
12 patients suffering from Behçet's disease have received immunosuppressive therapy. All patients have been given chlorambucil. In addition 5 patients who were threatened by an acute and permanent blindness from severe retinal vein involvement received antilymphocyte globulins. The follow-up ranges from 1 year up to 71/2 years with an average of 31/2 years. Complete recovery from ocular inflammation has been achieved in all patients. Visual acuity remained unchanged or improved in all patients but 1. Ocular recurrences occurred in 2 patients after decreasing the daily dose of chlorambucil and in 1 patient 2 years after the end of a 1-year treatment. The action of chlorambucil was not so constant upon systemic involvement of the disease than upon ocular inflammation. Nevertheless, 1 patient recovered from severe central nervous system involvement with hemiplegia. The review of the literature and comparison with our own experience leads to suggest that the discrepancy of the published results should be related to the variety of the immunosuppressive drugs which have been tried in Behçet's disease. Chlorambucil seems to be the most effective and the less toxic drug. But its action upon eye inflammation requires 2-3 months to take place. Therefore, in the most severe cases threatened by an acute and permanent blindness, the treatment should be started with antilymphocyte globulins.