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Behçet disease with vascular involvement: Effects of different therapeutic regimens on the incidence of new relapses
Scopus
Open Access Toplam 151 atıf DOI
Vascular involvement is one of the major causes of mortality and morbidity in Behcet disease (BD). There are no controlled studies for the management of vascular BD (VBD), and according to the EULAR recommendations, only immunosuppressive (IS) agents are recommended. In this study, we aimed to investigate the therapeutic approaches chosen by Turkish physicians during the initial event and relapses of VBD and the association of different treatment options with the relapses retrospectively. Patients with BD (n-936, female/male: 347/589, mean age: 37.6 ± 10.8) classified according to ISG criteria from 15 rheumatology centers in Turkey were included. The demographic data, clinical characteristics of the first vascular event and relapses, treatment protocols, and data about complications were acquired. VBD was observed in 27.7% (n - 260) of the patients during followup. In 57.3% of the VBD patients, vascular involvement was the presenting sign of the disease. After the first vascular event, ISs were given to 88.8% and AC treatment to 59.8% of the patients. Median duration of AC treatment was 13 months (1-204) and ISs, 22 months (1-204). Minor hemorrhage related to AC treatment was observed in 7 (4.7%) patients. Asecond vascular event developed in 32.9% (n=86) of the patients. The vascular relapse rate was similar between patients taking only ISs and AC plus IS treatments after the first vascular event (29.1% vs 22.4%, P=0.28) and was significantly higher in group taking only ACs than taking only ISs (91.6% vs 29.1%, P<0.001). During follow-up, a third vascular event developed in 17 (n = 6.5%) patients. The relapse rate was also similar between the patients taking only ISs and AC plus IS treatments after second vascular event (25.3% vs 20.8%, P=0.93). When multivariate analysis was performed, development of vascular relapse negatively correlated with only IS treatments. We did not find any additional positive effect of AC treatment used in combination with ISs in the course of vascular involvement in patients with BD. Severe complications related to AC treatment were also not detected. Our results suggest that short duration of IS treatments and compliance issues of treatment are the major problems in VBD associated with vascular relapses during follow-up.
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Diagnostic Performance of Lower Extremity Venous Wall Thickness and Laboratory Findings in the Diagnosis of the Behçet Disease
Scopus
Havuzumuzda 20 atıf almış
Background/Objective Behçet disease (BD) is not a single unique entity but a syndrome with different clinical phenotypes that can involve arterial and venous vessels of all sizes. To date, there has been no specific test or serum marker to measure and determine the severity of BD, and diagnosis remains based on clinical findings. This study aimed to assess lower extremity venous wall thickness (VWT) measured by ultrasound and laboratory findings and diagnostic performance in patients with BD. Methods A total of 106 participants were recruited from the rheumatology department in this single-center, case-control study. Participants meeting the eligibility criteria were divided into healthy controls (n = 52) and BD (n = 54). The VWT values of the common femoral vein, great saphenous vein, and popliteal vein were measured using ultrasonography. Laboratory data were obtained from the electronic registration database. Venous wall thicknesses and laboratory findings in patients with BD and healthy subjects were compared. Results Venous wall thickness of the lower extremity veins was higher in the BD group and higher in those with a history of deep vein thrombosis than in those without. The mean leukocyte, monocyte, erythrocyte sedimentation rate (ESR), C-reactive protein, plateletcrit (PCT), red cell distribution width (RDW), mean platelet volume (MPV) values, and monocyte-to-lymphocyte ratio (MLR) were higher in BD patients than in the control group. There was a correlation among increased VWT, ESR, PCT, MPV, RDW, and MLR. Conclusions C-reactive protein, ESR, MPV, PCT, MLR, RDW, and VWT can be used to assist in the diagnosis of BD.
Atıf Yapan Makale Bilgileri
Kurumlar (2)
Departments of Rheumatology
United States
Selçuk Tip Fakültesi
Konya, Turkey