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What is the impact of traditional risk factors for vascular affection on Behcet’s disease vascular involvement: a retrospective cohort study

Abstract

Background

To study the frequency, types, and outcome of vascular involvement in a cohort of Egyptian patients with Behcet’s disease (BD) and its relation to traditional risk factors for vascular affection.

Patients and methods

A retrospective cohort study was done involving 164 patients with BD diagnosed according to the criteria of the International Study Group for BD admitted to Cairo and Ain Shams Universities Hospitals from 2000 to 2017. They were reviewed to analyze the types, risk factors, and outcome of vascular involvement.

Results

A total of 148 men and 16 women were included in the study, with a mean age of 31.5±7.5 years. Their disease duration ranged from 1 to 36 years, with a mean of 7.3±5.5 years. Vascular involvement was present in 64 (39%), involving both venous and arterial sides of the circulation. Venous affection was more common than arterial (39 and 17%, respectively). No significant association was found between traditional risk factors for vascular affection (smoking, hypertension, diabetes, hyperlipidemia, and obesity) and vascular involvement in patients with BD. Although uncommon, arterial aneurysm (9.8%) is the most serious complication, as it may lead to mortality owing to aneurysm rupture and bleeding (representing 100% of deaths in this study).

Conclusion

Vascular involvement in patients with BD is mainly owing to the disease process itself and not owing to the effect of the traditional risk factors for vascular affection, reflecting the importance of focusing on treatment of the disease process. However, adjustment of these risk factors would lead to better health outcome for the vulnerable patients.

References

  1. Ulusan Z, Karadag S, Tasar M, Kalender M, Darcin O. Behcet’s disease and cardiovascular involvement: our experience of asymptomatic Behcet’s patients. Cardiovasc J Afr 2014; 25:63–66.

    Article  Google Scholar 

  2. Fei Y, Li X, Lin S, Song X, Wu Q, Zhu Y, et al. Major vascular involvement in Behcet’s disease: A retrospective study of 796 patients. Clin Rheumatol 2013; 32:845–852.

    Article  Google Scholar 

  3. Seyahi E, Cakmak OS, Tutar B, Arslan C, Dikici AS, Sut N, et al. Clinical and ultrasonographic evaluation of lower-extremity vein thrombosis in Behcet syndrome: an observational study. Medicine (Baltimore) 2015; 94: e1899.

    Article  Google Scholar 

  4. Tascilar K, Melikoglu M, Ugurlu S, Sut N, Caglar E, Yazici H. Vascular involvement in Behcet’s syndrome: a retrospective analysis of associations and the time course. Rheumatology (Oxford) 2014; 53:2018–2022.

    Article  CAS  Google Scholar 

  5. Demirtu?rk OS, Tu?nel HA, Alemdaroglu U. Behcet’s Disease(Book)Chapter 9: Vascular Manifestations of Behçet’s Disease. pages 149–189. DOI: 10.5772/intechopen.68765. In Tech, published May 31, 2017.

  6. Ho BL, Lin RT, Chen YF, Lin HF. Behcet’s disease with involvement of major arteries: a case report. Acta Neurol Taiwan 2008; 17:253–257.

    PubMed  Google Scholar 

  7. Seyahi E, Melikoglu M, Yazici H. Clinical features and diagnosis of Behcet’s syndrome. Int J Adv Rheumatol 2007; 5:8.

    Google Scholar 

  8. Kural-Seyahi E, Fresko I, Seyahi N, Ozyazgan Y, Mat C, Hamuryudan V, et al. The long-term mortality and morbidity of Behçet syndrome: a 2-decade outcome survey of 387 patients followed at a dedicated center. Medicine (Baltimore) 2003; 82:60.

    Article  Google Scholar 

  9. Ceylan N, Bayraktaroglu S, Erturk SM, Savas R, Alper H. Pulmonary and vascular manifestations of Behçet’s disease: imaging findings. Am J Roentgenol 2010; 194:W158–W164.

    Article  Google Scholar 

  10. Hamuryudan V, Er T, Seyahi E, Akman C, Tüzün H, Fresko I, et al. Pulmonary artery aneurysms in Behçet syndrome. Am J Med 2004; 117:867.

    Article  Google Scholar 

  11. Hackam DG, Anand SS. Emerging risk factors for atherosclerotic vascular disease. a critical review of the evidence. JAMA 2003; 290:932–940.

    PubMed  Google Scholar 

  12. Evereklioglu C. Current concepts in the etiology and treatment of Behçet disease. Surv Ophthalmol 2005; 50:297.

    Article  Google Scholar 

  13. International Study Group for Behçet’s Disease. Criteria for diagnosis of Behçet’s disease. Lancet 1990; 335:1078–1080.

    Google Scholar 

  14. Savey L, Resche-Rigon M, WechslerB, ComarmondC, PietteJ, Cacoub P, Saadoun D. Ethnicity and association with disease manifestations and mortality in Behçet’s disease. Orphanet J Rare Dis 2014; 9:42.

    Article  Google Scholar 

  15. Alaoui FZ, Moudatir M, Echchilali K, Benamour S, El Kabli H. Behcet’s Disease in Morocco: Report of1484 Cases. EULAR 2014: Scientific Abstrasct. Poster Presentations. Vasculitis.

  16. Al-Izzi M, El Bur M, Arif M. A diagnosis not to be missed: Behcet’s disease as a cause of dilated cardiomyopathy in a young Arab male patient. Int J Rheum Dis 2010; 13:97–99.

    Article  Google Scholar 

  17. Al Dalaan AN, Al Balaa SR, El Ramahi K, al-Kawi Z, Bohlega S, Bahabri S, et al. Behcet’s disease in Saudi Arabia. J Rheumatol 1994; 21:658–661.

    Google Scholar 

  18. Hamdan A, Mansour W, Uthman I, Masri A, Nasr E, Arayssi T. Behcet’s disease in Lebanon: clinical profile, severity and two-decade comparison. Clin Rheumatol 2005; 15:1–4.

    Google Scholar 

  19. Davatchi F, Shahram F, Chams-Davatchi C, Shams H, Nadji A, Akhlaghi M, et al. Behcet’s disease: from East to West. Clin Rheumatol 2010; 29:823–833.

    Article  Google Scholar 

  20. Sarica-Kucukoglu R, Akdag-Kose A, KayabalI M, Yazganoglu KD, Disci R, etal. Vascular involvement in Behçet’s disease: a retrospective analysis of 2319 cases. Int J Dermatol 2006; 45:919.

    Article  Google Scholar 

  21. Marzban M, Mandegar MH, Karimi A, et al. Cardiac and great vessel involvement in ‘Behcet’s disease. J Card Surg 2008; 23:765–768.

    Article  Google Scholar 

  22. Hammami S, Miniaoui I, Kchida M, Khelfa M, Chaabane I, Klii R, Kochtal I. Cardiovascular involvement in Behçet disease: a retrospective study. Arch Cardiovasc Dis Suppl 2016; 8:83.

    Google Scholar 

  23. Calamia KT, Schirmer M, Melikoglu M. Major vessel involvement in Behcet’s disease: an update. Curr Opin Rheumatol 2011; 23:24–31.

    Article  Google Scholar 

  24. Hatemi G, Silman A, Bang D, Bodaghi B, Chamberlain AM, et al. EULAR recommendations for the management of Behcet disease. Ann Rheum Dis 2008; 67:1656–1662.

    Article  CAS  Google Scholar 

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Correspondence to Marwa Abdo MD.

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Abdo, M., Alkemary, A. & El Mallah, R. What is the impact of traditional risk factors for vascular affection on Behcet’s disease vascular involvement: a retrospective cohort study. Egypt Rheumatol Rehabil 46, 257–261 (2019). https://doi.org/10.4103/err.err_27_19

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  • DOI: https://doi.org/10.4103/err.err_27_19

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