{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T12:12:19Z","timestamp":1753877539242,"version":"3.41.2"},"reference-count":6,"publisher":"Oxford University Press (OUP)","issue":"7","license":[{"start":{"date-parts":[[2019,7,5]],"date-time":"2019-07-05T00:00:00Z","timestamp":1562284800000},"content-version":"vor","delay-in-days":4,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,7,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>A 25-year-old woman presented with ophthalmic and neurological manifestations. Her ocular manifestations included bilateral uveitis, multifocal retinal phlebitis, vitreitis and multiple retinal haemorrhages. Her neurological manifestations included migrainous headaches with visual aura, transient sensory symptoms and posterior circulation Transient Ischemic Attack (TIA). Magnetic resonance imaging of the brain demonstrated lesions that involved the deep white matter lesions initially and progressed to also involve the juxta cortical white and deep grey matter and brain stem, but without further neurological manifestations. She was sequentially treated with intravenous and oral glucocorticoid, cyclophosphamide and mycophenolate mofetil, but she continued to suffer with persistent episodes of retinal haemorrhages. Cerebral Autosomal Dominant Arteriopathy with Subcortical Infarcts and Leukoencephalopathy (CADASIL), Susac syndrome and Behcet\u2019s disease were considered in the differential diagnosis. Genetic workup and clinical picture were not suggestive of the former two. Further history of oro-genital ulceration in younger age emerged, which pointed strongly towards a diagnosis of Behcet\u2019s disease with neurological involvement. She was treated with infliximab and methotrexate with complete resolution of her symptoms and withdrawal of corticosteroids for the first time in over two decades.<\/jats:p>","DOI":"10.1093\/omcr\/omz058","type":"journal-article","created":{"date-parts":[[2019,7,11]],"date-time":"2019-07-11T13:36:00Z","timestamp":1562852160000},"source":"Crossref","is-referenced-by-count":0,"title":["Pattern recognition is a sequential process\u2014accurate diagnosis and treatment 20\u00a0years after presentation"],"prefix":"10.1093","volume":"2019","author":[{"given":"Dimos","family":"Merinopoulos","sequence":"first","affiliation":[{"name":"Rheumatology Department, Norfolk and Norwich University Hospital, Norfolk, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Janak","family":"Saada","sequence":"additional","affiliation":[{"name":"Radiology Department, Norfolk and Norwich University Hospital, Norfolk, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Colin","family":"Jones","sequence":"additional","affiliation":[{"name":"Ophthalmology Department, Norfolk and Norwich University Hospital, Norfolk, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chetan","family":"Mukhtyar","sequence":"additional","affiliation":[{"name":"Rheumatology Department, Norfolk and Norwich University Hospital, Norfolk, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2019,7,5]]},"reference":[{"key":"2019071109355073400_ref1","first-page":"1078","article-title":"Criteria for diagnosis of Behcet\u2019s disease","volume":"335","author":"International Study Group for Behcet\u2019s Disease","year":"1990","journal-title":"Lancet"},{"key":"2019071109355073400_ref2","doi-asserted-by":"crossref","first-page":"148","DOI":"10.1038\/ncprheum0436","article-title":"Beh\u00e7et's syndrome: disease manifestations, management, and advances in treatment","volume":"3","author":"Yazici","year":"2007","journal-title":"Nat Clin Pract Rheumatol"},{"key":"2019071109355073400_ref3","first-page":"865","article-title":"Treatment of ocular inflammatory disease with glucocorticoids and cyclophosphamide pulses [article in Spanish]","volume":"123","author":"Cuchacovich","year":"1995","journal-title":"Rev Med Chil"},{"key":"2019071109355073400_ref4","doi-asserted-by":"crossref","first-page":"2478","DOI":"10.1002\/art.21231","article-title":"Efficacy of infliximab in the treatment of uveitis that is resistant to treatment with the combination of azathioprine, cyclosporine, and corticosteroids in Beh\u00e7et's disease: an open-label trial","volume":"52","author":"Tugal-Tutkun","year":"2005","journal-title":"Arthritis Rheum"},{"key":"2019071109355073400_ref5","doi-asserted-by":"crossref","first-page":"736","DOI":"10.1093\/rheumatology\/kem034","article-title":"Anti-TNF therapy in the management of Behcet's disease\u2013review and basis for recommendations","volume":"46","author":"Sfikakis","year":"2007","journal-title":"Rheumatology (Oxford)"},{"key":"2019071109355073400_ref6","doi-asserted-by":"crossref","first-page":"295","DOI":"10.1016\/S0140-6736(01)05497-6","article-title":"Effect of infliximab on sight threatening panuveitis in Beh\u00e7et\u2019s disease","volume":"358","author":"Sfikakis","year":"2001","journal-title":"Lancet"}],"container-title":["Oxford Medical Case Reports"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/omcr\/article-pdf\/2019\/7\/omz058\/28927441\/omz058.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2019,7,11]],"date-time":"2019-07-11T13:36:03Z","timestamp":1562852163000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/omcr\/article\/doi\/10.1093\/omcr\/omz058\/5528356"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,7,1]]},"references-count":6,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2019,7,5]]},"published-print":{"date-parts":[[2019,7,1]]}},"URL":"https:\/\/doi.org\/10.1093\/omcr\/omz058","relation":{},"ISSN":["2053-8855"],"issn-type":[{"type":"electronic","value":"2053-8855"}],"subject":[],"published-other":{"date-parts":[[2019,7]]},"published":{"date-parts":[[2019,7,1]]},"article-number":"omz058"}}