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Behçet syndrome manifestations and activity in the United States versus Turkey --
a cross-sectional cohort comparison
#MMPMID24931953
Sibley C
; Yazici Y
; Tascilar K
; Khan N
; Bata Y
; Yazici H
; Goldbach-Mansky R
; Hatemi G
J Rheumatol
2014[Jul]; 41
(7
): 1379-84
PMID24931953
show ga
OBJECTIVE: To compare clinical manifestations and activity of Behçet syndrome
(BS) in the United States versus Turkey using validated outcome measures.
METHODS: Consecutive patients with BS from the US National Institutes of Health
(NIH), New York University, and the University of Istanbul were evaluated.
Disease activity was measured using the Behçet's Syndrome Activity Scale (BSAS)
and the Behçet's Disease Current Activity Form (BDCAF) with quality of life
measured by the Behçet Disease Quality of Life (BDQOL) form. One-way ANOVA,
t-tests, and multivariate regression analyses were performed. RESULTS: Mean age
did not differ between sites; however, more women were seen in the United States
versus in Turkey (p < 0.001), and disease duration was longer in the United
States (p = 0.02). Organ manifestations were similar for oral and genital ulcers,
skin disease, arthralgia, eye disease, and thrombosis. However, more
gastrointestinal (p < 0.001) and neurologic disease (p = 0.003) was seen in the
United States. BSAS and BDCAF scores were worse in the United States compared to
Turkey (p = 0.013 and < 0.001, respectively). Worse mean BDQOL scores were
observed at the NIH compared to Istanbul (not significant). Multivariable
regression models showed worse scores in ethnically atypical patients for BSAS
and BDCAF (p = 0.04 and p = 0.001), American patients for BDCAF (p = 0.01), older
age for BDCAF (p = 0.005), and women for BDQOL (p = 0.01). CONCLUSION:
Demographic and clinical manifestations of BS differ between sites with higher
disease activity in the United States compared to Turkey. Referral patterns, age,
sex, ethnicity, and country of origin may be important in these differences.
These observations raise the question of whether pathogenic mechanisms differ in
Turkish and American patients.
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