Neuro-Behcet's disease in the setting of active COVID-19 infection

BACKGROUND: Cases of SARS-COV-2 triggering or exacerbating autoimmune responses has been described in the literature, and it has shown that use of steroids in non-severe COVID-19 may potentially increase mortality. CASE PRESENTATION: A 22 year-old African-American man presented with headache, weight, loss, and oral/scrotal ulcerations. CASE REPORT: Neurological exam revealed somnolence and right hemiplegia. MRI was remarkable multiple enhancing lesions involving the brainstem and left hemisphere. He was found to have a positive SARS-CoV-2 test. Work-up was unrevealing, and he was diagnosed with Neuro-Behcet's disease (NBD) based on the International Criteria for Behcet's Disease (ICBD)ackspaceD)BackspaceBackspacep. The patient was treated with systemic steroids, which resulted in both clinical and radiological improvement of his disease without exacerbation of his SAR-CoV-2 infection. CONCLUSIONS: This case presentation suggests that IV steroids may be safe in the treatment of NBD in adult patients presenting with SARS-CoV-2 infection.