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MAGIC Syndrome

Dr Sampurna Roy  MD



There is magic, but you have to be the magician. You have to make the magic happen. - Sidney Sheldon


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In 1985, Firestein et al.described 5 patients with relapsing polychondritis and Behçet's disease and introduced the term "MAGIC" syndrome.

The acronym MAGIC syndrome includes:  

MAG = Mouth and Genital ulcers

 Diagram: "Mouth and Genital Ulcers"

IC = Inflamed Cartilage

Diagram: "Inflamed Red Ears (Cartilage)"

Relapsing Polychondritis and Behçet's disease are different multisystem inflammatory diseases.

Relapsing Polychondritis:

Visit: Pathology of Relapsing Polychondritis



Behçet's disease: Behçet's disease can be diagnosed from criteria which were proposed by the International Study Group for Behçet´s Disease in 1990. 

Required Criteria:

Recurrent oral ulceration - minor or major aphtous or herpetiform ulceration, observed by the doctor or  by the patient, which has recurred at least three times in a twelve month period.

Minor Criteria:

Recurrent genital ulceration - genital aphthous ulceration or scarring, especially in men observed by the doctor or by the patient.

Ocular lesions - (1) anterior uveitis, posterior uveitis, cells in the vitreous humour and in slit lamp exam, or (2),retinal vasculitis

Skin lesions - (1) erythema nodosum-like lesions, pseudo folliculitis, papulopustular lesions, or  (2) acneiform nodules consistent with Behcet's disease, observed by the doctor  and in patients   patients not on corticosteroid treatment,

Positive Pathergy test - erythematous papule larger than 2 mm at prick site checked by a doctor 48 hours after obliquely pricking the avascular part of the skin to a depth of 5mm.

The presence of one major and at least two minor criteria are necessary to establish diagnosis.


Patients in MAGIC syndrome usually present with chondritis, oral aphthous ulcers, genital ulcers, ocular inflammation and arthritis.

 Kotter et all suggested that MAGIC syndrome is not a disease entity, but merely the association of Behçet's disease with polychondritis.


Further reading:

The MAGIC syndrome (mouth and genital ulcers with inflamed cartilage).

MAGIC or not MAGIC--does the MAGIC (mouth and genital ulcers with inflamed cartilage) syndrome really exist? A case report and review of the literature.

Mouth and genital ulcers with inflamed cartilage: MAGIC syndrome. Five patients with features of relapsing polychondritis and Behçet's disease

Mouth and genital ulcers with inflamed cartilage (MAGIC syndrome): a case report and literature review.

A case of severe MAGIC syndrome treated successfully with the tumor necrosis factor-alpha inhibitor infliximab.

Mouth and genital ulcers with inflamed cartilage (MAGIC) syndrome complicated by aneurysmal aortitis.

Aortic aneurysm in MAGIC syndrome successfully managed with combined anti-TNF-alpha and stent grafting.

Syndrome in question. MAGIC syndrome.

Magic syndrome and true aortic aneurysm.

Criteria for diagnosis of Behçet's disease. International Study Group for Behçets Disease.  


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Dr  Sampurna Roy  MD

Consultant Histopathologist (Kolkata - India)




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