Therapeutic experience of hyperbaric oxygenation in entero-Behcet syndrome

Thalidomide for treatment of intestinal involvement of juvenile-onset Behçet disease

BACKGROUND

Thalidomide has been identified and its anti-inflammatory and immunomodulatory properties clarified. This report expands our report of 2 entero-Behçet disease children who developed significant steroid toxicity and improved dramatically with thalidomide.

METHODS

We studied the effects of thalidomide in 7 juvenile-onset patients with severe, recurrent intestinal involvement of Behçet disease. Thalidomide was given at an initial dose of 2 mg/kg per day, and the dose was increased to 3 mg/kg per day if necessary (3 of 7 patients) or decreased to 1-0.5 mg/kg per day according to the responses to the drug.

RESULTS

All 7 patients showed dramatic improvement in clinical symptoms with thalidomide therapy, and they successfully discontinued steroid therapy. Patients receiving thalidomide were monitored for prolonged neurotoxicity, and the treatment and a few side effects were well tolerated by all patients.

CONCLUSIONS

Our results indicate that thalidomide can be an efficacious medication in appropriately selected patients with some inflammatory bowel diseases with many chances of success.

Severe skin ulceration associated with Wegener's granulomatosis: successful treatment with hyperbaric oxygen and prostaglandin E1

Abstract A 36-year-old woman patient with intractable skin ulcers associated with Wegener's granulomatosis was successfully cured by combination therapy with hyperbaric oxygenation therapy (HBO) and intravenous prostaglandin E1 (PGE1). Treatment for 4 months with prednisolone, intravenous PGE1, and cyclophosphamide did not result in healing of the multiple skin lesions on her legs. Repeated HBO with intravenous PGE1 therapy over 6 months resulted in a complete healing of the skin ulcers. We recommend the use of HBO combined with PGE1 for severe cutaneous lesions associated with generalized vasculitis.