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Clinical characteristics of behçet's disease in palestine, a retrospective cohort study
Abdalrahim Daraghma1, Lamar Baidoun1, Samaa Nazzal1
1Department of Medicine, Faculty of Medicine and Allied Medical Sciences, An-Najah National University, Nablus, Palestine.
Insights
Behçet
Area of Science:
- Rheumatology
- Vasculitis Research
- Systemic Inflammatory Diseases
Background:
- Behçet's Disease (BD) is a chronic, systemic vasculitis with unknown cause.
- It presents with recurrent ulcers, ocular, vascular, and other organ involvement.
- Diagnosis relies on clinical criteria, lacking specific lab tests.
Purpose of the Study:
- To describe the prevalence and characteristics of Behçet's Disease in Palestine.
- To provide insights into disease patterns for improved diagnosis and management.
Main Methods:
- Retrospective cohort study of 60 BD patients in the West Bank and Jerusalem.
- Diagnosis confirmed using International Criteria for Behçet's Disease (ICBD).
- Data collected via chart review and interviews; complications assessed using BODI.
Main Results:
- Most common initial symptoms: oral ulcers (96.7%), genital ulcers (86.7%), ocular lesions (66.7%).
- Frequent complications included vascular events (36.7%) and skin ulcerations (33.3%).
- Neurological manifestations (25%) and pathergy test (18.3%) were less common.
Conclusions:
- Oral and genital ulcers are the most common BD manifestations in Palestine.
- Vascular events and visual impairment are frequent complications.
- BD characteristics showed no significant gender difference in this cohort.
Background:
Behçet's Disease (BD) is a chronic, systemic vasculitis of unknown etiology that affects multiple organ systems. It is characterized by recurrent oral and genital ulcers, ocular involvement, affecting arteries and veins of all sizes. It is more prevalent in countries along the ancient Silk Road. Diagnosis is primarily clinical, as there are no specific laboratory tests. The International Criteria for BD (ICBD) was developed to improve diagnostic accuracy. Management requires a multidisciplinary approach, with treatment strategies depending on disease severity. Despite BD's significant morbidity and diverse clinical manifestations, its prevalence and characteristics remain to be described in Palestine. This research provides critical insights into disease patterns and contributes to improved diagnosis and management in Palestine.
Methods:
A retrospective cohort study was conducted in the period from Aug 2024 until March 2025 in rheumatology clinics across the West Bank and Jerusalem. 60 Patients diagnosed with BD based on ICBD (score ≥ 4) were included. Exclusion criteria were cognitive impairment, incomplete records, or non-residence in Palestine. Sixty patients were enrolled. Data was collected via chart review and patient interviews. Disease-related complications were assessed using the Behçet's Overall Damage Index (BODI) to ensure standardized evaluation.
Results:
The male to female ratio was 1.14:1. In addition, the most common initial clinical presentations were oral aphthous ulcers (96.7%), genital aphthous (86.7%), ocular lesions (66.7%), skin lesions noted (46.7%), while vascular lesions occurred in (30%). Neurological manifestations and positive Pathergy test were (25%) and (18.3%), respectively. Regarding complications, the most common were vascular events (36.7%), skin ulcerations (33.3%), mucocutaneous scars (20%), avascular necrosis (13.3%), osteoporotic fractures (10%). Regarding complications in the eye, anterior segment changes presented (15%), posterior segment changes (8.3%), visual impairment in one eye (33.3%), and (13.3%) in both. Neurological complications were less frequent and there was no difference in characteristics between the genders.
Conclusion:
The most common manifestations were oral aphthous ulcers, followed by genital ulcers, neurological manifestations, and pathergy was the least frequent. The most frequently reported complications were vascular events, skin ulceration, and visual impairment, while neuropsychiatric complications were the least frequent, and there was no gender difference in BD characteristics.
Research Registry Number:
No trial registry number.
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