FRI0506 Clinical analysis of behÇet's disease manifestations in 453 egyptian patients: gender comparison. (12th June 2018)

• Record Type: Journal Article
• Authors: Elshahaly, M.; Omar, I.; Bassiouni, H.
• Is Part Of: Annals of the rheumatic diseases. Volume 77(2018)Supplement 2
• Page Start: 781
• Page End: 781
• Publication Date: 2018-06-12
• Subjects: Rheumatism -- Periodicals; 616.723005
• DOI: 10.1136/annrheumdis-2018-eular.2824
• Languages: English
• ISSNs: 0003-4967

Abstract

Abstract : Background: Behçet's disease (BD) is characterised by the presence of vasculitis of veins and arteries of all sizes. 1 Persistent oral and genital ulcers are hallmarks of the disease. BD may be associated with inflammation of eyes, joints, vessels, GIT, nervous system, and other systems. 2 70% of BD patients suffer from ocular complications mainly recurrent uveitis that may lead to loss of vision. 3 Objectives: To describe the demographic and clinical features including ocular manifestations of BD in Egyptian patients and to compare the incidence of disease complications between males and females. Methods: 453 subjects fulfilling 1990 Classification criteria for BD were included. Detailed history, physical examination and complete ocular examination were done. Both, a rheumatologist and an ophthalmologist did clinical examination and follow-up. Further comparison of disease manifestations between both genders was done. Patients were followed up every 2 weeks for 4 years for monitoring of disease complications. Results: Median (range) age of patients was 45 32–63 years old. Our sample included 297 (65.6%) males and 156 (34.3%) females. Patients' disease duration ranged between one to 16 years. At baseline, acute phase reactants (ESR and CRP) were significantly higher in females compared to males (p<0.01) indicating a higher disease activity. Oral ulcers were present in 100% of patients. Prevalence of genital ulcers, erythema nodosum and joint involvement was similar between both sexes. Subcutaneous thrombophlebitis and follicular papules were more common in males compared to females (p=0.009 and p=0.041 respectively). Recurrent iridocyclitis was found in 100% of patients. All ocular findings were significantly more common in females compared to males except retinal haemorrhages that were more common in males (49.8% vs 37.2%). Incidence of secondary cataract and glaucoma in addition to vitreous opacities were similar between both sexes. 14.8% of patients had GIT manifestations including Budd-Chiari syndrome in 10 males and 5 females; bloody diarrhoea was found in 10 males. Disturbed bowel habits were present in 27 males and 10 females. Deep venous thrombosis (DVT) was found in 11.8% of males and 3.2% of females. Mediastinal vein syndrome was found in 3.7% of males only, pulmonary artery aneurysm in 1.3% of males and 3.2% of females. Aseptic meningitis and hemiplegia were found 3.4% and 3% of males respectively. 1.7% males and 3.2% females suffered from brain stem involvement. Superior sagittal sinus thrombosis was present in 3.4% females. Conclusions: BD has wide range of complications most commonly oral ulcers and recurrent iridocyclitis. Surprisingly, disease activity was higher in females at baseline and ocular complications were more common in females compared to males. References: [1] Nair JR, Moots RJ. Behcet's disease. Clin Med (Lond) 2017Feb;17(1):71–77. [2] Kural-Seyahi E, Fresko I, Seyahi N, et al. The long-term mortality and morbidity of Behcet's syndrome. A 2 decade outcome survey of 387 patients followed at a dedicated center. Medicine (Baltimore)2003:82:60–76. [3] Kitaichi N, Miyazaki A, Iwata D, Ohno S, Stanford MR, Chams H. Ocular features of Behçet's disease: An international collaborative study. Br J Ophthalmol2007;91(12):1579–1582. Disclosure of Interest: None declared