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Published in: Clinical Rheumatology 11/2020

01-11-2020 | Original Article

Clinical manifestations of Behçet’s disease in a large cohort of Chinese patients: gender- and age-related differences

Authors: Chaoran Li, Lu Li, Xiuhua Wu, Jing Shi, Jinjing Liu, Jiaxin Zhou, Li Wang, Xinping Tian, Xiaofeng Zeng, Wenjie Zheng

Published in: Clinical Rheumatology | Issue 11/2020

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Abstract

Objectives

To investigate the clinical characteristics of Bechet’s disease (BD) with respect to gender and age in China.

Method

Clinical data of 489 BD patients admitted to Peking Union Medical College Hospital (PUMCH) and registered by the BD registry database established by PUMCH from March 2014 to January 2019 were collected and analyzed in this study. Demographics, medical histories, clinical manifestations, laboratory test results, imaging findings, assessment of disease activity, treatment regimen, as well as the outcomes were reviewed.

Results

A total of 489 BD patients were included in this study, among them 286 males (58.5%) and 203 females (41.5%) with a male-to-female ratio of 1.41 and a median age of 34 years (interquartile range 28–44 years old). The results revealed that ocular lesions (P = 0.005), vascular lesions(P < 0.001), pseudofolliculitis (P < 0.001), and positive pathergy test (P = 0.002) were more commonly found in males, while genital ulceration was more prevalent in females (P < 0.001). Vascular lesions (P = 0.024) and gastrointestinal ulcers (P = 0.010) were more common in BD patients after the age of 40, while pseudofolliculitis was more common in patients under the age of 40 (P = 0.004) and ocular lesions (P = 0.017) occurred mainly in patients under the age of 35. Male predominance of ocular involvement was more apparent in their third decades (Padjusted< 0.006), while vascular lesions were prominently presented in male patients at the age of 30–40 (Padjusted= 0.006). Female predominance of genital ulcers was observed in patients at the age of 30–40 (Padjusted< 0.006).

Conclusions

The clinical characteristics of BD were different with respect to gender and age.
Key Points
Ocular and vascular lesions, pseudofolliculitis, and positive pathergy test were more common in male BD patients.
• Genital ulceration showed female predominance in BD patients.
• Vascular lesions and gastrointestinal ulcers were more common in older BD patients.
• Pseudofolliculitis and ocular lesions occurred mainly in younger BD patients.
Literature
1.
go back to reference Sakane T, Nishikawa M (1993) Behcet’s disease. N Engl J Med 341:416–420 Sakane T, Nishikawa M (1993) Behcet’s disease. N Engl J Med 341:416–420
2.
go back to reference Kim JN, Kwak SG, Choe J-Y, Kim S-K (2017) The prevalence of Behçet’s disease in Korea: data from Health Insurance Review and Assessment Service from 2011 to 2015. Clin Exp Rheumatol 35:38–42PubMed Kim JN, Kwak SG, Choe J-Y, Kim S-K (2017) The prevalence of Behçet’s disease in Korea: data from Health Insurance Review and Assessment Service from 2011 to 2015. Clin Exp Rheumatol 35:38–42PubMed
3.
go back to reference Madanat WY, Alawneh KM, Smadi MM, Saadeh SS, Yazici H (2017) The prevalence of Behçet’s disease in the north of Jordan: a hospital-based epidemiological survey. Clin Exp Rheumatol 35(Suppl 108):51–54PubMed Madanat WY, Alawneh KM, Smadi MM, Saadeh SS, Yazici H (2017) The prevalence of Behçet’s disease in the north of Jordan: a hospital-based epidemiological survey. Clin Exp Rheumatol 35(Suppl 108):51–54PubMed
4.
go back to reference Zhuoli Z, Jinmin P, Xiaomeng H, Yi D (2007) The meta-analysis of 1996 patients with Behcet’s disease. Med J Beijing 29:10–12 Zhuoli Z, Jinmin P, Xiaomeng H, Yi D (2007) The meta-analysis of 1996 patients with Behcet’s disease. Med J Beijing 29:10–12
5.
go back to reference Ideguchi H, Suda A, Takeno M, Ueda A, Ohno S, Ishigatsubo Y (2011) Behcet disease: evolution of clinical manifestations. Medicine 90:125CrossRef Ideguchi H, Suda A, Takeno M, Ueda A, Ohno S, Ishigatsubo Y (2011) Behcet disease: evolution of clinical manifestations. Medicine 90:125CrossRef
6.
go back to reference Yazici H, Hamuryudan V, Hizli N, Yurdakul S, Mat C, Dimitriyadis I (1996) The ten-year mortality in Behcet’s syndrome. Br J Rheumatol 35:139–141CrossRef Yazici H, Hamuryudan V, Hizli N, Yurdakul S, Mat C, Dimitriyadis I (1996) The ten-year mortality in Behcet’s syndrome. Br J Rheumatol 35:139–141CrossRef
7.
go back to reference Bonitsis NG, Luong Nguyen LB, Lavalley MP, Papoutsis N, Altenburg A, Kötter I et al (2015) Gender-specific differences in Adamantiades-Behçet’s disease manifestations: an analysis of the German registry and meta-analysis of data from the literature. Rheumatology 54:121CrossRef Bonitsis NG, Luong Nguyen LB, Lavalley MP, Papoutsis N, Altenburg A, Kötter I et al (2015) Gender-specific differences in Adamantiades-Behçet’s disease manifestations: an analysis of the German registry and meta-analysis of data from the literature. Rheumatology 54:121CrossRef
8.
go back to reference Ishido T, Horita N, Takeuchi M, Kawagoe T, Shibuya E, Yamane T, Hayashi T, Meguro A, Ishido M, Minegishi K, Yoshimi R, Kirino Y, Kato S, Arimoto J, Ishigatsubo Y, Takeno M, Kurosawa M, Kaneko T, Mizuki N (2017) Clinical manifestations of Behçet’s disease depending on sex and age: results from Japanese nationwide registration. Rheumatology 56:1918–1927CrossRef Ishido T, Horita N, Takeuchi M, Kawagoe T, Shibuya E, Yamane T, Hayashi T, Meguro A, Ishido M, Minegishi K, Yoshimi R, Kirino Y, Kato S, Arimoto J, Ishigatsubo Y, Takeno M, Kurosawa M, Kaneko T, Mizuki N (2017) Clinical manifestations of Behçet’s disease depending on sex and age: results from Japanese nationwide registration. Rheumatology 56:1918–1927CrossRef
9.
go back to reference Davatchi F, Chams-Davatchi C, Shams H, Nadji A, Faezi T, Akhlaghi M, Sadeghi Abdollahi B, Ashofteh F, Ghodsi Z, Mohtasham N, Shahram F (2016) Adult Behcet’s disease in Iran: analysis of 6075 patients. Int J Rheum Dis 19:95–103CrossRef Davatchi F, Chams-Davatchi C, Shams H, Nadji A, Faezi T, Akhlaghi M, Sadeghi Abdollahi B, Ashofteh F, Ghodsi Z, Mohtasham N, Shahram F (2016) Adult Behcet’s disease in Iran: analysis of 6075 patients. Int J Rheum Dis 19:95–103CrossRef
10.
go back to reference Ugurlu N, Bozkurt S, Bacanli A, Akman-Karakas A, Uzun S, Alpsoy E (2015) The natural course and factors affecting severity of Behçet’s disease: a single-center cohort of 368 patients. Rheumatol Int 35:2103–2107CrossRef Ugurlu N, Bozkurt S, Bacanli A, Akman-Karakas A, Uzun S, Alpsoy E (2015) The natural course and factors affecting severity of Behçet’s disease: a single-center cohort of 368 patients. Rheumatol Int 35:2103–2107CrossRef
11.
go back to reference Khabbazi A, Noshad H, Shayan FK, Kavandi H, Hajialiloo M, Kolahi S (2018) Demographic and clinical features of Behcet’s disease in Azerbaijan. Int J Rheum Dis 21:1114–1119CrossRef Khabbazi A, Noshad H, Shayan FK, Kavandi H, Hajialiloo M, Kolahi S (2018) Demographic and clinical features of Behcet’s disease in Azerbaijan. Int J Rheum Dis 21:1114–1119CrossRef
12.
go back to reference Salvarani C, Pipitone N, Catanoso MG, Cimino L, Tumiati B, Macchioni P, Bajocchi G, Olivieri I, Boiardi L (2007) Epidemiology and clinical course of Behçet’s disease in the Reggio Emilia area of northern Italy: a seventeen-year population-based study. Arthritis Rheum 57:171–178CrossRef Salvarani C, Pipitone N, Catanoso MG, Cimino L, Tumiati B, Macchioni P, Bajocchi G, Olivieri I, Boiardi L (2007) Epidemiology and clinical course of Behçet’s disease in the Reggio Emilia area of northern Italy: a seventeen-year population-based study. Arthritis Rheum 57:171–178CrossRef
13.
go back to reference Sharquie KE, Al-Rawi Z, Hatem A, Al-Araji A (2002) The influence of age of onset and patient’s sex on the prevalence of clinical manifestations of Behcet’s disease in Iraqi patients. Ann Saudi Med 22:239–241CrossRef Sharquie KE, Al-Rawi Z, Hatem A, Al-Araji A (2002) The influence of age of onset and patient’s sex on the prevalence of clinical manifestations of Behcet’s disease in Iraqi patients. Ann Saudi Med 22:239–241CrossRef
14.
go back to reference Hamzaoui A, Jaziri F, Ben ST, Said IBGF, Lamloum M, Smiti KM et al (2014) Comparison of clinical features of Behcet disease according to age in a Tunisian cohort. Acta Med Iran 52:748PubMed Hamzaoui A, Jaziri F, Ben ST, Said IBGF, Lamloum M, Smiti KM et al (2014) Comparison of clinical features of Behcet disease according to age in a Tunisian cohort. Acta Med Iran 52:748PubMed
15.
go back to reference Zhang Z, He F, Shi Y (2013) Behcet’s disease seen in China: analysis of 334 cases. Rheumatol Int 33:645–648CrossRef Zhang Z, He F, Shi Y (2013) Behcet’s disease seen in China: analysis of 334 cases. Rheumatol Int 33:645–648CrossRef
16.
go back to reference Shang Y, Han S, Li J, Ren Q, Song F, Chen H (2009) The clinical feature of Behçet’s disease in Northeastern China. Yonsei Med J 50:630–636CrossRef Shang Y, Han S, Li J, Ren Q, Song F, Chen H (2009) The clinical feature of Behçet’s disease in Northeastern China. Yonsei Med J 50:630–636CrossRef
17.
go back to reference Wang LY, Zhao DB, Gu J, Dai SM (2010) Clinical characteristics of Behcet’s disease in China. Rheumatol Int 30:1191–1196CrossRef Wang LY, Zhao DB, Gu J, Dai SM (2010) Clinical characteristics of Behcet’s disease in China. Rheumatol Int 30:1191–1196CrossRef
18.
go back to reference Geng L, Ohno S, Wang YH, Higuchi M (1985) Clinical observations on Behcet’s disease in Tianjin, China. Jpn J Ophthalmol 29:310–314PubMed Geng L, Ohno S, Wang YH, Higuchi M (1985) Clinical observations on Behcet’s disease in Tianjin, China. Jpn J Ophthalmol 29:310–314PubMed
19.
go back to reference Wechsler B, Davatchi F, Mizushima Y, Hamza M, Dilsen N, Kansu E et al (1990) International study group for Behçet’s disease. Lancet 335:1078–1080 Wechsler B, Davatchi F, Mizushima Y, Hamza M, Dilsen N, Kansu E et al (1990) International study group for Behçet’s disease. Lancet 335:1078–1080
20.
go back to reference Davatchi F, Assaad-Khalil S, Calamia KT, Crook JE, Sadeghi-Abdollahi B, Schirmer M et al (2014) The international criteria for Behcet’s disease (ICBD): a collaborative study of 27 countries on the sensitivity and specificity of the new criteria. J Eur Acad Dermatol Venereol 28:338–347CrossRef Davatchi F, Assaad-Khalil S, Calamia KT, Crook JE, Sadeghi-Abdollahi B, Schirmer M et al (2014) The international criteria for Behcet’s disease (ICBD): a collaborative study of 27 countries on the sensitivity and specificity of the new criteria. J Eur Acad Dermatol Venereol 28:338–347CrossRef
21.
go back to reference Mar S, Rocha VB, Garcia LC (2017) Behçet’s disease: review with emphasis on dermatological aspects. An Bras Dermatol 92:452–464CrossRef Mar S, Rocha VB, Garcia LC (2017) Behçet’s disease: review with emphasis on dermatological aspects. An Bras Dermatol 92:452–464CrossRef
22.
go back to reference Seema K, Alan S, Gulsen AD, Saeed B, Afshin BH, Constantinescu CS et al (2013) Diagnosis and management of Neuro-Behcet’s disease: international consensus recommendations. J Neurol 333:e720–e720 Seema K, Alan S, Gulsen AD, Saeed B, Afshin BH, Constantinescu CS et al (2013) Diagnosis and management of Neuro-Behcet’s disease: international consensus recommendations. J Neurol 333:e720–e720
23.
go back to reference Chun L (2017) Reclassification of age groups and their implications. Popul Res 41:16–25 Chun L (2017) Reclassification of age groups and their implications. Popul Res 41:16–25
24.
go back to reference Davatchi F, Chams-Davatchi C, Shams H, Shahram F, Nadji A, Akhlaghi M et al (2016) Behcet's disease: epidemiology, clinical manifestations, and diagnosis. Expert Rev Clin Immunol 13:57CrossRef Davatchi F, Chams-Davatchi C, Shams H, Shahram F, Nadji A, Akhlaghi M et al (2016) Behcet's disease: epidemiology, clinical manifestations, and diagnosis. Expert Rev Clin Immunol 13:57CrossRef
25.
go back to reference Khairallah M, Accorinti M, Muccioli C, Kahloun R, Kempen JH (2012) Epidemiology of Behçet disease. Ocul Immunol Inflamm 20:324CrossRef Khairallah M, Accorinti M, Muccioli C, Kahloun R, Kempen JH (2012) Epidemiology of Behçet disease. Ocul Immunol Inflamm 20:324CrossRef
26.
go back to reference Kuralseyahi E, Fresko I, Seyahi N, Ozyazgan Y, Mat C, Hamuryudan V et al (2003) The long-term mortality and morbidity of Behçet syndrome: a 2-decade outcome survey of 387 patients followed at a dedicated center. Medicine 82:60–76CrossRef Kuralseyahi E, Fresko I, Seyahi N, Ozyazgan Y, Mat C, Hamuryudan V et al (2003) The long-term mortality and morbidity of Behçet syndrome: a 2-decade outcome survey of 387 patients followed at a dedicated center. Medicine 82:60–76CrossRef
27.
go back to reference Yazici H, Pazarli H, Yurdakul S, Ozyazgan Y, Ersanli M (1984) Influence of age of onset and patient’s sex on the prevalence and severity of manifestations of Behcet’s syndrome. Ann Rheum Dis 43:783-789 Yazici H, Pazarli H, Yurdakul S, Ozyazgan Y, Ersanli M (1984) Influence of age of onset and patient’s sex on the prevalence and severity of manifestations of Behcet’s syndrome. Ann Rheum Dis 43:783-789
Metadata
Title
Clinical manifestations of Behçet’s disease in a large cohort of Chinese patients: gender- and age-related differences
Authors
Chaoran Li
Lu Li
Xiuhua Wu
Jing Shi
Jinjing Liu
Jiaxin Zhou
Li Wang
Xinping Tian
Xiaofeng Zeng
Wenjie Zheng
Publication date
01-11-2020
Publisher
Springer International Publishing
Published in
Clinical Rheumatology / Issue 11/2020
Print ISSN: 0770-3198
Electronic ISSN: 1434-9949
DOI
https://doi.org/10.1007/s10067-020-05026-2

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