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. 2017 Dec;4(4):239-244.
doi: 10.5152/eurjrheum.2017.17112. Epub 2017 Nov 3.

Behçet's disease in the United States: A single center descriptive and comparative study

Nathan C Kilian  1 , Amr H Sawalha  1   2
Affiliations

Behçet's disease in the United States: A single center descriptive and comparative study

Nathan C Kilian et al. Eur J Rheumatol. 2017 Dec.

Abstract

Objective: Behçet's disease is heterogeneous with clinical variability across ethnicities and geographic locations. The goal of this study was to analyze the clinical characteristics of our multi-ethnic Behçet's disease cohort at the University of Michigan.

Material and methods: A detailed patient characterization was performed. Differences in disease characteristics between men and women, and between patients fulfilling the International Criteria for Behçet's Disease (ICBD) and the International Study Group criteria (ISG) were determined in our cohort.

Results: A total of 114 patients with a male to female ratio of ~ 1:4 were included. All patients met the ICBD criteria, including 76 who also met the ISG criteria. Over 95% of patients had recurrent genital ulcers, which is higher than generally reported. Retinitis was 5.3 times more likely in men than in women (p=0.009), and arthralgia was 3.3 times more likely in women than men (p=0.048). When comparing cohorts derived from the two different criteria, the ISG cohort had more skin manifestations (OR=3.3, p=0.0006). Acneiform lesions were associated with ~8 times higher odds of developing retinitis in our patients (p=0.0008), and superficial thrombophlebitis was associated with a trend for higher odds of developing uveitis (OR=4.1, p=0.057). Using the ICBD criteria, 38 additional patients were identified compared to only using the ISG criteria. Of these patients, 28 presented with only mucosal ulceration with or without joint involvement.

Conclusion: We characterize Behçet's disease in a multi-ethnic cohort from North America. Using ICBD criteria in the United States significantly increases the likelihood of identifying Behçet's disease, particularly in patients with isolated mucosal involvement who constitute a substantial subset of patients in this region.

Keywords: Behçet’s disease; Michigan; United States; criteria; manifestations; sex bias.

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Conflict of interest statement

Conflict of Interest: No conflict of interest was declared by the authors.

Figures

Figure 1
Figure 1
The frequency of Behçet’s disease manifestations in patients fulfilling the ISG criteria compared to patients fulfilling the ICBD criteria in our study ISG: international study group criteria; ICBD: international criteria for Behçet’s disease
See this image and copyright information in PMC

References

    1. Criteria for diagnosis of Behcet’s disease. International Study Group for Behcet’s Disease. Lancet. 1990;335:1078–80. - PubMed
    1. International Team for the Revision of the International Criteria for Behcet’s D. The International Criteria for Behcet’s Disease (ICBD): a collaborative study of 27 countries on the sensitivity and specificity of the new criteria. J Eur Acad Dermatol Venereol. 2014;28:338–47. - PubMed
    1. Ahmed Z, Rossi ML, Yong S, Martin DK, Walayat S, Cashman M, et al. Behcet’s disease departs the ‘Silk Road’: a case report and brief review of literature with geographical comparison. J Community Hosp Intern Med Perspect. 2016;6:30362. https://doi.org/10.3402/jchimp.v6.30362. - DOI - PMC - PubMed
    1. Yurdakul S, Hamuryudan V, Yazici H. Behcet syndrome. Curr Opin Rheumatol. 2004;16:38–42. https://doi.org/10.1097/00002281-200401000-00008. - DOI - PubMed
    1. Chang HK, Kim JW. The clinical features of Behcet’s disease in Yongdong districts: analysis of a cohort followed from 1997 to 2001. J Korean Med Sci. 2002;17:784–9. https://doi.org/10.3346/jkms.2002.17.6.784. - DOI - PMC - PubMed

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