Plasma Homocysteine in Behcet's Disease: A Systematic Review and Meta-Analysis

2022 ◽  
Author(s):  
Mira Merashli ◽  
Tommaso Bucci ◽  
Daniele Pastori ◽  
Pasquale Pignatelli ◽  
Alessia Arcaro ◽  
...  
Keyword(s):  
Systematic Review ◽  
Behçet’S Disease ◽  
Behcet’S Disease ◽  
Behçet's Disease ◽  
Clinical Manifestations ◽  
Plasma Homocysteine ◽  
Vascular Involvement ◽  
Ocular Involvement ◽  
Female Ratio ◽  
Behcet's Disease

Abstract Aim To evaluate the relevance of plasma homocysteine (HC) in Behcet's disease (BD) and its clinical manifestations. Methods Systematic review of EMBASE and PubMed databases according to PRISMA guidelines from inception to July 2021; random-effects meta-analyses for continuous outcomes. Results The search strategy retrieved 48 case–control (2,669 BD and 2,245 control participants) and 5 cohort studies (708 BD participants). Plasma HC was higher in BD than in controls (p < 0.0001) with wide heterogeneity (I2  = 89.7%) that remained unchanged after sensitivity analysis according to year of article publication, age of BD participants, study size, study quality, method of HC determination, and male/female ratio >1.5; some pooled ethnicities explained a small part of the heterogeneity (I2  = 16.3%). Active BD participants had higher HC than inactive ones (p < 0.0001), with moderate heterogeneity (I2  = 49.2%) that disappeared after removal of an outlier study with very high disease activity. BD participants with any vascular involvement had higher HC than those without (p < 0.0001) with wide heterogeneity (I2  = 89.7%); subgroup analysis on venous thrombosis only changed neither effect size (p < 0.0001) nor heterogeneity (I2  = 72.7%). BD participants with ocular involvement had higher HC than those without (p < 0.0001) with moderate heterogeneity (I2  = 40.3%). Conclusion Although causality cannot be inferred, the consistency of the elevation of plasma HC in BD, particularly in patients with active disease, with vascular and ocular involvement suggests an intrinsic involvement of HC in these clinical manifestations.

Vascular manifestations of Behçet's disease: report of a case and review of the literature

2011 ◽  
Vol 26 (6) ◽  
pp. 249-253 ◽  
Author(s):  
T Kotsis ◽  
K G Moulakakis ◽  
S Mylonas ◽  
V Andrikopoulos
Keyword(s):  
Behçet’S Disease ◽  
Behcet’S Disease ◽  
Inferior Vena ◽  
Recent Literature ◽  
Behçet's Disease ◽  
Vena Cava ◽  
Clinical Manifestations ◽  
Vascular Involvement ◽  
Thrombotic Occlusion ◽  
Behcet's Disease

Adamantiades–Behçet's disease (ABD) is a relapsing vasculitis of unknown aetiology and variable clinical manifestations. The syndrome can be presented in a myriad of ways and can involve nearly every organ. Although vascular involvement is not included among the ABD diagnostic criteria, it is a unique clinical manifestation in adults with a potentially devastating outcome. We report an ABD case, presenting with a thrombotic occlusion of the inferior vena cava. The authors review the recent literature, emphasizing the spectrum of vascular manifestations accompanying Behçet's disease.

scholarly journals Severe Behçet’s disease equally affects both genders in Egyptian patients: A multicentre retrospective follow-up study

Reumatismo ◽  
2020 ◽  
Vol 71 (4) ◽  
pp. 218-225
Author(s):  
D.H.S. Attia ◽  
R.A. Abdel Noor
Keyword(s):  
Gender Differences ◽  
Behçet’S Disease ◽  
Behcet’S Disease ◽  
Behçet's Disease ◽  
Vascular Involvement ◽  
Venous Disease ◽  
Female Ratio ◽  
Behcet's Disease ◽  
Organ Systems ◽  
Egyptian Patients

Behçet’s disease is a relapsing multisystemic disease. Its highest prevalence is seen along the Silk Road. While several studies reported gender disparities, others didn’t. Scarce data are available about the Arabs and the gender differences detected in some ethnicities could not be applied to others. Our study aimed to detect gender differences among a cohort of adult Egyptian patients with Behçet’s disease. Medical files of 255 adult patients diagnosed with Behçet’s disease at the Rheumatology and Rehabilitation Department of Kasr Al-Aini Hospital, Cairo University and the Internal Medicine Department of Tanta University, between 2002 and 2018, were retrospectively reviewed. The demographic features, the cumulative clinical features, the use, if any, of an intravenous pulse of methylprednisolone and immunosuppressive/biological drugs, and the frequency of the cumulative damage to the different organ systems were described. The disease severity score was calculated as well. The study revealed a prominent male predominance; the male to female ratio was 6.7:1. Acne/pseudofolliculitis was more common in males (28.6% vs 13.2%, p=0.046); the same was observed regarding any vascular involvement and peripheral venous disease (36.3% vs 18.4%, p=0.03 and 30.4% vs 13.2%, p=0.03, respectively). On the other hand, encephalitis and cranial nerve lesions were more prevalent in females (15.8% vs 6%, p=0.03 and 10.5% vs 3.2%, p=0.04, respectively). Severe Behçet’s disease equally affects Egyptian males and females. BD should not be considered a benign disease in Egyptian females. The same quality of medical care should be equally offered to both genders.

Clinical and Demographical Characteristics of Familial Behçet’s Disease (Southeast Marmara Region)

Dermatology ◽  
2019 ◽  
Vol 235 (5) ◽  
pp. 407-412 ◽  
Author(s):  
Zübeyde Ceylan Kalın ◽  
Hayriye Sarıcaoğlu ◽  
Serkan Yazici ◽  
Kenan Aydoğan ◽  
Emel Bülbül Başkan
Keyword(s):  
Behçet’S Disease ◽  
Behcet’S Disease ◽  
Behçet's Disease ◽  
Familial Aggregation ◽  
Vascular Involvement ◽  
Neurological Involvement ◽  
Ocular Involvement ◽  
Marmara Region ◽  
Behcet's Disease ◽  
First Degree Relatives

Background: Familial aggregation in Behçet’s disease (BD) has been reported in Turkish and Japanese populations. While the frequency of familial cases has been reported to be 2–5% worldwide, this rate reaches up to 15% in the Middle East. Objective: This study aimed to determine the incidence of familial BD cases followed in the BD polyclinic and to compare their clinical and demographic characteristics to those observed in sporadic cases. Methods: Data related to BD patients who were followed between 1995 and 2014 were collected from computerized archive records and were assessed for detailed family histories. Only first-degree relatives (brother, sister, mother, father, children) were considered to be cases of familial BD. Clinical and demographic ­features were retrieved. Our BD polyclinic is located in the Southeast Marmara Region in Turkey. Results: BD was detected in 36 first-degree relatives of 33 patients out of 840 patients with BD. A total of 45 patients were diagnosed as familial BD;23 were female, and 22 were male. In our patients, the incidence of familial BD was determined to be 3.9%. The rates for HLA-B5 positivity, ocular involvement, genital ulcers, and erythema nodosum were determined to be 86.6% (26/30), 26.6%, 82.2%, and 60%, respectively. None of the patients had neurological involvement, but 2 had vascular involvement. Conclusion: This study may contribute to the epidemiological data of BD from Turkey.

scholarly journals Behçet’s disease in clinical practice

2013 ◽  
Vol 94 (4) ◽  
pp. 545-548
Author(s):  
R F Khamitov ◽  
L Y Palmova ◽  
Z N Yakupova ◽  
E R Khasanova
Keyword(s):  
Behçet’S Disease ◽  
Behcet’S Disease ◽  
Behçet's Disease ◽  
Retinal Vasculitis ◽  
Clinical Manifestations ◽  
Specific Treatment ◽  
Skin Lesions ◽  
Female Ratio ◽  
Behcet's Disease ◽  
Pathergy Test

Behçet’s disease is a chronic relapsing multisystemic vasculitis involving vessels of different diameter. The disease is characterized by involvement of skin and mucosa, eyes, gastrointestinal tract, joints, vessels, genitourinary system and neurological symptoms. According to data, male/female ratio is 2-10:1 The etiology of the disease is still unclear. Diagnosis is mainly based on thorough analysis of clinical manifestations. According to the International Study Group for Behçet’s Disease Diagnostic Criteria, combination of recurrent oral aphthosis and at least any two of the following: severe or scarring genital aphthosis, eye lesions (posterior uveitis, retinal vasculitis), skin lesions (nodular erythema, pseudofolliculitis, acne-like lesions) and positive pathergy test is needed to classify the patient as a patient with Behçet’s disease. Several clinical subtypes of Behçet’s disease are distinguished depending on predominant involvement of different organs and systems, including skin and mucosa, joints, eyes, or neurological manifestations. There are no specific laboratory tests for Behçet’s disease. The treatment approaches are variable depending on clinical manifestations. The effect of systemic corticosteroids, colchicine, azathioprine, chlorambucil, cyclophosphamide, sulfasalazine, methotrexate, cyclosporine, infliximab was proven. All the abovementioned requires the good clinical knowledge on Behçet’s disease from practicing doctors of different specialties, particularly - physicians. A case of highly active acute Behçet’s disease with nose, pharynx, eye and oral cavity mucosa, scrotum skin involvement is presented in the article. Questions of differential diagnosis are reviewed, specific treatment program with efficacy analysis is presented.

scholarly journals Gender Differences in Behçet’s Disease Associated Uveitis

2014 ◽  
Vol 2014 ◽  
pp. 1-8 ◽  
Author(s):  
Didar Ucar-Comlekoglu ◽  
Austin Fox ◽  
H. Nida Sen
Keyword(s):  
Gender Differences ◽  
Behçet’S Disease ◽  
Behcet’S Disease ◽  
Behçet's Disease ◽  
Clinical Manifestations ◽  
Skin Lesions ◽  
Vascular Involvement ◽  
Unknown Etiology ◽  
Behcet's Disease ◽  
Male Patients

Behçet’s disease is a systemic vasculitis of unknown etiology, characterized by oral and genital ulceration, skin lesions, and uveitis as well as vascular, central nervous system, and gastrointestinal system involvement. It is prevalent in the Middle East, Mediterranean, and Eastern Asia. The aim of this review is to evaluate the gender differences in clinical manifestations of Behçet’s disease, treatment responses, mortality, and morbidity. Behçet’s disease has been reported to be more prevalent in males from certain geographic regions and particular ethnic groups; however, recent reports indicate more even gender distribution across the world. There are gender differences in clinical manifestations and severity of the disease. Ocular manifestations, vascular involvement, and neurologic symptoms are more frequently reported in male patients whereas oral and genital ulcers, skin lesions, and arthritis occur more frequently in female patients. The disease can have a more severe course in males, and overall mortality rate is significantly higher among young male patients.

Hyperhomocysteinaemia is associated with uveitis but not with deep venous thrombosis in Behçet's disease

2004 ◽  
Vol 42 (12) ◽  
Author(s):  
Moncef Feki ◽  
Habib Houman ◽  
Mehdi Ghannouchi ◽  
Monia Smiti-Khanfir ◽  
Kamel Hamzaoui ◽  
...  
Keyword(s):  
Venous Thrombosis ◽  
Behçet’S Disease ◽  
Healthy Subjects ◽  
Behcet’S Disease ◽  
Behçet's Disease ◽  
Clinical Manifestations ◽  
Plasma Homocysteine ◽  
Vitamin B ◽  
Behcet's Disease ◽  
Age And Sex

AbstractPlasma homocysteine was assessed in Behçet's disease (BD) patients in order to determine the prevalence of hyperhomocysteinaemia in BD and to test its association with clinical manifestations of the disease. The study included 59 patients with BD and 118 age- and sex-matched healthy subjects. Plasma homocysteine, vitamin B

scholarly journals Consensus classification criteria for paediatric Behçet's disease from a prospective observational cohort: PEDBD

2015 ◽  
Vol 75 (6) ◽  
pp. 958-964 ◽  
Author(s):  
Isabelle Koné-Paut ◽  
Fahrad Shahram ◽  
Martha Darce-Bello ◽  
Luca Cantarini ◽  
Rolando Cimaz ◽  
...  
Keyword(s):  
Behçet’S Disease ◽  
Behcet’S Disease ◽  
Behçet's Disease ◽  
Disease Onset ◽  
Clinical Signs ◽  
Clinical Manifestations ◽  
Vascular Involvement ◽  
Data Set ◽  
Behcet's Disease ◽  
Therapeutic Trials

BackgroundWe aimed to describe the main features of Behçet's disease (BD) in children in the largest prospective cohort to date and to propose a classification.MethodsAn international expert consensus group was formed to define a data set of minimal symptoms for the inclusion of patients. Patients were entered prospectively during 66 months. Experts classified patients on a consensus basis. The concordance of two international classifications was analysed in confirmed patients with BD. Comparisons of subgroups of patients helped define consensus criteria. BD-associated clinical manifestations were also investigated in three control diseases extracted from an independent data set (Eurofever).FindingsIn total, 42 centres from 12 countries included 230 patients; data for 219 (M/F ratio=1) could be analysed. The experts classified 156 patients (71.2%) as having confirmed BD. Males more often than females showed cutaneous, ocular and vascular symptoms and females more often genital aphthosis. Age at disease onset and skin and vascular involvement were lower for European than non-European children. Oral aphthosis was the presenting sign for 81% (179/219) of patients. The mean delay to the second symptom was 2.9±2.2 years. International classifications were not concordant with the expert classification. Our paediatric classification contains six categories, a minimum of three signs (each in a distinct category) defining paediatric BD. Three clinical signs discriminated our cohort from the Eurofever cohorts.InterpretationWe present a comprehensive description of a large cohort of patients from both European and non-European countries and propose the first classification of paediatric BD for future therapeutic trials.

scholarly journals AB0478 CORONARY ATHEROSCLEROSIS IN BEHCET’S DISEASE

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1537.1-1537
Author(s):  
R. Goloeva ◽  
Z. Alekberova
Keyword(s):  
Behçet’S Disease ◽  
Coronary Atherosclerosis ◽  
Behcet’S Disease ◽  
Behçet's Disease ◽  
Subclinical Atherosclerosis ◽  
Disease Onset ◽  
Atherogenic Index ◽  
Female Ratio ◽  
Behcet's Disease ◽  
The Mean

Background:Behcet’s disease (BD) is systemic vasculitis, which affects all types and sizes of vessels. Increased carotid intima-media thickness (IMT) is parameter associated with subclinical atherosclerosis.Objectives:To determine the prevalence of atherosclerosis in pts with BD.Methods:95 BD pts were evaluated and 45 healthy controls matched for age and gender.IMT was assessed by high-resolution B-mode ultrasonography. Serum concentration of high-sensitivity C-reactive protein (hs CRP) was measured by immunonephelometric assay (BN-100 Analyzer; Dade Behring). Lipid profile evaluation included total cholesterol, TGs, HDL, LDL and atherogenic index.Results:The male-to-female ratio was 3,7:1, the mean age of pts was 29.7 (23-35) yrs, the mean age at the disease onset - 19,9 (14-25) yrs, the mean disease duration - 9,6 (4-15) yrs.Conclusion:Coronary atherosclerosis in BD pts was lower than what we expected. The thinning IMT may be one of the risk factors for aneurysm formation in pts with BD.Disclosure of Interests:None declared

scholarly journals Old and New Challenges in Uveitis Associated with Behçet’s Disease

2021 ◽  
Vol 10 (11) ◽  
pp. 2318
Author(s):  
Julie Gueudry ◽  
Mathilde Leclercq ◽  
David Saadoun ◽  
Bahram Bodaghi
Keyword(s):  
Behçet’S Disease ◽  
Structural Damage ◽  
Behcet’S Disease ◽  
Behçet's Disease ◽  
Systemic Vasculitis ◽  
Retinal Vasculitis ◽  
Unknown Origin ◽  
Current Data ◽  
Ocular Involvement ◽  
Behcet's Disease

Behçet’s disease (BD) is a systemic vasculitis disease of unknown origin occurring in young people, which can be venous, arterial or both, classically occlusive. Ocular involvement is particularly frequent and severe; vascular occlusion secondary to retinal vasculitis may lead to rapid and severe loss of vision. Biologics have transformed the management of intraocular inflammation. However, the diagnosis of BD is still a major challenge. In the absence of a reliable biological marker, diagnosis is based on clinical diagnostic criteria and may be delayed after the appearance of the onset sign. However, therapeutic management of BD needs to be introduced early in order to control inflammation, to preserve visual function and to limit irreversible structural damage. The aim of this review is to provide current data on how innovations in clinical evaluation, investigations and treatments were able to improve the prognosis of uveitis associated with BD.

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