Behcet’s Disease: Change of Clinical Picture during the Time

Introduction: In a study presented 15 years ago, we showed that the clinical picture of the disease was changing toward milder forms. The aim of this study was to repeat the study in a larger group of 7140 patients. Patients & Methods: patients were divided into four quartiles of 1785 each (Q1 to Q4), according to their first visit. Eighty symptoms/signs were compared by chi2 test and Odd Ratios (OR) in whole patients and in those having a disease duration of 6 to 20 years (893 in Q1 versus 1075 in Q4). Figures of OR≥2.5 or ≤0.4 were taken as differences clinically relevant. Results: There was no clinically relevant difference in male/female ratio between Q1/Q4. Oral aphthosis was seen less frequently in selected patients in Q1 (OR=0.20), while the following were seen more frequently: pseudofolliculitis (OR=4.93), Gastrointestinal manifestations (OR=2.45), Gastroduodenitis (OR=5.39), peptic ulcer (OR=6.13), cardiac manifestations (OR=3.65) epididymitis (OR=3.93), overlap/association (autoimmune diseases, cancer, etc., OR=11.99), ESR>100 (R=2.30), Positive Pathergy test (OR=2.38), Proteinuria (OR=3.28), cast (OR=3.63), and positive VDRL/RPR (OR=14.18). Conclusion: Oral aphthosis was seen less frequently in Q1, perhaps due to less sensitive criteria. While, several other manifestations were seen more frequently, a sign of more multisymptom disease in Q1.