The role of ambiental agents in Behçet's disease

To evaluate the potential role of environmental agents in the etiopathogenesis of Behçet's disease.

Twenty-eight Behçet's disease patients and 56 controls were recruited prospectively from the outpatient rheumatic disease clinic at the Escola Paulista de Medicina between July 1991 and July 1992. Behçet's disease was diagnosed using one of the accepted sets of criteria (Japanese Committee, International Committee, O'Duffy, Mason & Barnes, and James). The control patients, who had other rheumatic diseases, were matched on age and sex with the Behçet's disease patients. To investigate environmental factors, a standardized questionnaire was administered to each subject during an interview. Clinical and laboratory investigations were performed in each subject according to a predefined protocol.

Analysis using the Chi-square test or Fisher's exact test (Cochran's restriction) disclosed significant associations between Behçet's disease and a history of herpes simplex virus type 1 infection or streptococcal infection.

Despite the small sample size, our data strongly support a role of infectious agents in the etiopathogenesis of Behçet's disease. Further studies in larger patient populations are needed to confirm our results.