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Successful mesenchymal stem cell treatment of leg ulcers complicated by Behcet disease: A case report and literature review.

Abstract Behçet disease (BD) is a recurrent vasculitis characterized by oral and genital mucous membrane ulcers, uveitis, and skin lesions but only rarely leg ulcers. To our knowledge, no efficacious therapy has been described for BD patients with complicating, destructive leg ulcers.
PMID
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Authors

Mayor MeshTerms

Behcet Syndrome

Leg Ulcer

Prednisone

Thalidomide

Keywords
Journal Title medicine
Publication Year Start




PMID- 29668637
OWN - NLM
STAT- MEDLINE
DCOM- 20180424
LR  - 20180424
IS  - 1536-5964 (Electronic)
IS  - 0025-7974 (Linking)
VI  - 97
IP  - 16
DP  - 2018 Apr
TI  - Successful mesenchymal stem cell treatment of leg ulcers complicated by Behcet
      disease: A case report and literature review.
PG  - e0515
LID - 10.1097/MD.0000000000010515 [doi]
AB  - RATIONALE: Behcet disease (BD) is a recurrent vasculitis characterized by oral
      and genital mucous membrane ulcers, uveitis, and skin lesions but only rarely leg
      ulcers. To our knowledge, no efficacious therapy has been described for BD
      patients with complicating, destructive leg ulcers. PATIENT CONCERNS: Here, We
      report the case of a 55-year-old woman with generalized erythema nodosum-like,
      papulopustular lesions, recurrent oral and genital ulcers accompanied with
      recurrent leg ulcers and trouble walking. DIAGNOSES: Based upon the patient's
      clinical feature and positive pathergy test , BD was confirmed. INTERVENTIONS:
      Conventional immunosuppressive therapy and anti-tumor necrosis factor inhibitors,
      adalimumab and etanercept, had no demonstrable clinical effect. Mesenchymal stem 
      cell (MSC) injection combined with low-dose prednisone and thalidomide, however, 
      completely ameliorated the ulcers on one leg, significantly improved ulcers on
      the other leg, and returned normal function to both legs. OUTCOMES: The
      ulcerative lesions remained in remission, and the affected leg functioned
      normally after 34 months' follow-up. LESSONS: Our experience suggests that MSC
      infusion might be a potentially successful therapy for intractable drug-resistant
      BD patients with concomitant leg ulcer.
FAU - Li, Yanhong
AU  - Li Y
AD  - Department of Rheumatology, West China Hospital, Sichuan University, Chengdu,
      Sichuan, PR China.
FAU - Wang, Zhongming
AU  - Wang Z
AD  - Department of Rheumatology, West China Hospital, Sichuan University, Chengdu,
      Sichuan, PR China.
FAU - Zhao, Yi
AU  - Zhao Y
AD  - Department of Rheumatology, West China Hospital, Sichuan University, Chengdu,
      Sichuan, PR China.
FAU - Luo, Yubin
AU  - Luo Y
AD  - Department of Rheumatology, West China Hospital, Sichuan University, Chengdu,
      Sichuan, PR China.
FAU - Xu, Wangdong
AU  - Xu W
AD  - Department of Rheumatology, West China Hospital, Sichuan University, Chengdu,
      Sichuan, PR China.
FAU - Marion, Tony N
AU  - Marion TN
AD  - Department of Microbiology, Immunology, and Biochemistry, The University of
      Tennessee Health Science Center, Memphis, TN.
FAU - Liu, Yi
AU  - Liu Y
AD  - Department of Rheumatology, West China Hospital, Sichuan University, Chengdu,
      Sichuan, PR China.
LA  - eng
PT  - Case Reports
PT  - Journal Article
PL  - United States
TA  - Medicine (Baltimore)
JT  - Medicine
JID - 2985248R
RN  - 0 (Immunosuppressive Agents)
RN  - 4Z8R6ORS6L (Thalidomide)
RN  - FYS6T7F842 (Adalimumab)
RN  - OP401G7OJC (Etanercept)
RN  - VB0R961HZT (Prednisone)
SB  - AIM
SB  - IM
MH  - Adalimumab/administration & dosage/adverse effects
MH  - *Behcet Syndrome/complications/diagnosis
MH  - Dose-Response Relationship, Drug
MH  - Drug Resistance
MH  - Drug Substitution/methods
MH  - Etanercept/administration & dosage/adverse effects
MH  - Female
MH  - Humans
MH  - Immunosuppressive Agents/administration & dosage/adverse effects
MH  - *Leg Ulcer/etiology/physiopathology/therapy
MH  - Mesenchymal Stem Cell Transplantation/*methods
MH  - Middle Aged
MH  - *Prednisone/administration & dosage/adverse effects
MH  - *Thalidomide/administration & dosage/adverse effects
MH  - Treatment Outcome
EDAT- 2018/04/19 06:00
MHDA- 2018/04/25 06:00
CRDT- 2018/04/19 06:00
PHST- 2018/04/19 06:00 [entrez]
PHST- 2018/04/19 06:00 [pubmed]
PHST- 2018/04/25 06:00 [medline]
AID - 10.1097/MD.0000000000010515 [doi]
AID - 00005792-201804200-00063 [pii]
PST - ppublish
SO  - Medicine (Baltimore). 2018 Apr;97(16):e0515. doi: 10.1097/MD.0000000000010515.