LETTER
Treatment of Behcet Disease with Pentoxifylline
Mustafa Arici, MD;
Sedat Kiraz, MD; and
Ihsan Ertenli, MD
15 March 1997 | Volume 126 Issue 6 | Pages 493-494
TO THE EDITOR:
In their recent report [1], Yasui and associates suggest that pentoxifylline treatment improves neutrophil function and clinical symptoms, particularly the ocular involvement in three patients with Behcet disease. The anti-inflammatory and immunomodulatory effects of pentoxifylline have been found to be applicable in some rheumatologic disorders [2]. In patients with anticardiolipin antibody-induced retinal vasculitis, for example, pentoxifylline is a favored therapeutic approach [3]. In addition, the presence of anticardiolipin antibodies has been reported to have pathogenetic implications in the development of retinal vascular derangements in Behcet disease [4]. However, the paucity of the literature makes it difficult to draw definite conclusions about the use of pentoxifylline in patients who have Behcet disease that manifests with retinal involvement and anticardiolipin antibodies. The novel trial by Yasui and colleagues is encouraging, but it lacks important data on the presence of anticardiolipin antibodies. Because the pathogenetic mechanisms underlying the vascular complications of Behcet disease are multifactorial and not readily clear, it would be somewhat inadequate to attribute the alleviation of ocular symptoms to just the modifying effect of pentoxifylline on neutrophil function. Therefore, certain confounding variables, particularly anticardiolipin antibody status, should also be considered in the evaluation of the precise efficacy of pentoxifylline in the vascular involvement in Behcet disease.
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Author and Article Information
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Hacettepe University Faculty of Medicine, Ankara, Turkey
1. Yasui K, Ohta K, Kobayashi M, Aizawa T, Komiyama A. Successful treatment of Behcet disease with pentoxifylline. Ann Intern Med. 1996; 124:891-3.
2. Anaya JM, Espinoza LR. Phosphodiesterase inhibitor pentoxifylline: an antiinflammatory/immunomodulatory drug potentially useful in some rheumatic diseases. J Rheumatol. 1995; 22:595-9.
3. Bick RL, Baker WF. The antiphospholipid and thrombosis syndromes. Med Clin North Am. 1994; 78:667-84.
4. Hull RG, Harris EN, Gharavi AE, Tincani A, Asherson RA, Valesini G, et al. Anticardiolipin antibodies: occurrence in Behcet's syndrome. Ann Rheum Dis. 1984; 43:746-8.
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