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To the Editor.—
In the QUESTIONS AND ANSWERS section (227:1066, 1974), a 16-year-old youth with a nocturnal seizure disorder and canker sores was described. It is possible that this combination may be a manifestation of Behçet disease. Although not mentioned by the discussant, canker sores, along with an unexplained neurologic disease, should raise the suspicion of this entity. The youth resembled one (case 1) of our ten patients with Behçet disease described in the Annals of Internal Medicine 75:561, 1971. In our patient, the initial manifestations were aphthous stomatitis and grand mal seizure disorder. Subsequent events during a ten-year period were polyarthritis, colitis, erythema nodosum, thrombophlebitis, and quadriparesis, culminating in colectomy for ulcerative bowel disease.Other clues to the diagnosis of Behçet disease, besides the originally described triad of oral ulceration, genital ulceration, and uveitis, are cutaneous vasculitis, nonerosive arthritis, colitis resembling that in Crohn disease, phlebitis, and rarely, arterial aneurysms.
O'Duffy JD. Possible Behçet Disease. JAMA. 1974;228(10):1228. doi:10.1001/jama.1974.03230350018010
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