Skip to main content
Erschienen in: Clinical Rheumatology 4/2021

12.09.2020 | Original Article

Risk factors of disease activity in patients with Behçet’s syndrome

verfasst von: Cheng-cheng Hou, Jian-long Guan

Erschienen in: Clinical Rheumatology | Ausgabe 4/2021

Einloggen, um Zugang zu erhalten

Abstract

Objectives

To investigate the clinical characteristics and laboratory data in Behçet’s syndrome (BS) patients in China and analyze the risk factors of disease activity.

Method

A retrospective analysis method was used and the demographic data and laboratory results were collected from 174 BS patients. Univariate and multivariate logistic regression analyses were used to analyze the demographic data and laboratory indexes whether that are risk factors or not of disease activity.

Results

The most common clinical manifestations of BS patients enrolled were mouth ulceration (48.85%), followed by erythema nodosum (20.69%), and eye involvement (13.75%), while the least common was headache (0%). Most active BS patients (96.55%) used 2 or ≥ 3 immunosuppressants to control disease, while most inactive patients (75%) used 0 or 1 immunosuppressant. The associated risk factors of disease activity consisted of disease duration, neutrophil-to-lymphocyte ratio (NLR), white blood cells, red blood cells, hemoglobin, platelets, fibrin degradation products, IgG, IgM, complement 3, complement 4, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), albumin, albumin-to-globulin ratio (AGR), and high-density lipoprotein (HDL) (P < 0.05 or P = 0.00). Disease duration (≤ 60 months) (OR 8.49, 95% CI 2.09–34.49, P = 0.003), NLR (≥ 2) (OR 8.68, 95% CI 2.12–35.49, P = 0.003), CRP (≥ 10 mg/L) (OR 41.12, 95% CI 8.43–200.70, P = 0.000), ESR (≥ 20 mm/H) (OR 9.60, 95% CI 2.41–38.18, P = 0.001), and AGR (< 1.5) (OR 12.42, 95% CI 2.92–52.80, P = 0.001) were the independent risk factors of disease activity in BS patients.

Conclusions

Attention should be paid to the risk factors of disease activity and the medicine should be adjusted correspondingly.
Key Points
The current diagnosis and efficacy evaluation of Behçet’s syndrome (BS) mainly relied on clinical symptoms, while there are no specific laboratory biomarkers for reference.
In this study, we found that disease duration (≤ 60 months), neutrophil-to-lymphocyte ratio (≥ 2), C-reactive protein (≥ 10 mg/L), erythrocyte sedimentation rate (≥ 20 mm/H), and albumin-to-globulin ratio (< 1.5) were the independent risk factors of disease activity in BS patients.
In the ROC curve analysis, we found that erythrocyte sedimentation rate, C-reactive protein, and neutrophil-to-lymphocyte ratio could predict whether BS patients were active.
Literatur
1.
Zurück zum Zitat Yazici H, Seyahi E, Hatemi G, Yazici Y (2018) Behcet syndrome: a contemporary view. Nat Rev Rheumatol 14:107–119CrossRef Yazici H, Seyahi E, Hatemi G, Yazici Y (2018) Behcet syndrome: a contemporary view. Nat Rev Rheumatol 14:107–119CrossRef
2.
Zurück zum Zitat Tong BN, Liu XL, Xiao J, Su GF (2019) Immunopathogenesis of Behcet's disease. Front Immunol 10:665CrossRef Tong BN, Liu XL, Xiao J, Su GF (2019) Immunopathogenesis of Behcet's disease. Front Immunol 10:665CrossRef
3.
Zurück zum Zitat Pleyer U, Stubiger N, Kotter I (2019) Behcet's syndrome. Gefasschirurgie 24:144–151CrossRef Pleyer U, Stubiger N, Kotter I (2019) Behcet's syndrome. Gefasschirurgie 24:144–151CrossRef
4.
Zurück zum Zitat Salmaninejad A, Zamani MR, Shabgah AG, Hosseini S, Mollaei F, Hosseini N, Sahebkar A (2019) Behcet's disease: an immunogenetic perspective. J Cell Physiol 234:8055–8074CrossRef Salmaninejad A, Zamani MR, Shabgah AG, Hosseini S, Mollaei F, Hosseini N, Sahebkar A (2019) Behcet's disease: an immunogenetic perspective. J Cell Physiol 234:8055–8074CrossRef
5.
Zurück zum Zitat Hammad M, Shehata OZ, Abdel-Latif SM, El-Din AMM (2018) Neutrophil/lymphocyte ratio and platelet/lymphocyte ratio in Behcet's disease: which and when to use? Clin Rheumatol 37:2811–2817CrossRef Hammad M, Shehata OZ, Abdel-Latif SM, El-Din AMM (2018) Neutrophil/lymphocyte ratio and platelet/lymphocyte ratio in Behcet's disease: which and when to use? Clin Rheumatol 37:2811–2817CrossRef
6.
Zurück zum Zitat Hatemi G, Esatoglu SN, Yazici Y (2018) Biomarkers in vasculitis. Curr Opin Rheumatol 30:30–35CrossRef Hatemi G, Esatoglu SN, Yazici Y (2018) Biomarkers in vasculitis. Curr Opin Rheumatol 30:30–35CrossRef
7.
Zurück zum Zitat Gholijani N, Ataollahi MR, Samiei A, Aflaki E, Shenavandeh S, Kamali-Sarvestani E (2017) An elevated pro-inflammatory cytokines profile in Behcet's disease: a multiplex analysis. Immunol Lett 186:46–51CrossRef Gholijani N, Ataollahi MR, Samiei A, Aflaki E, Shenavandeh S, Kamali-Sarvestani E (2017) An elevated pro-inflammatory cytokines profile in Behcet's disease: a multiplex analysis. Immunol Lett 186:46–51CrossRef
8.
9.
Zurück zum Zitat Park JS, Kang MI, Ha YJ, Song JJ, Park YB, Lee SK, Lee SW (2017) Serum anti-lysozyme is associated with disease activity of Behcet's disease. Int J Rheum Dis 20:261–268CrossRef Park JS, Kang MI, Ha YJ, Song JJ, Park YB, Lee SK, Lee SW (2017) Serum anti-lysozyme is associated with disease activity of Behcet's disease. Int J Rheum Dis 20:261–268CrossRef
10.
Zurück zum Zitat Lee YH, Song GG (2018) Neutrophil-to-lymphocyte ratio, mean platelet volume and platelet-to-lymphocyte ratio in Behcet's disease and their correlation with disease activity: a meta-analysis. Int J Rheum Dis 21:2180–2187CrossRef Lee YH, Song GG (2018) Neutrophil-to-lymphocyte ratio, mean platelet volume and platelet-to-lymphocyte ratio in Behcet's disease and their correlation with disease activity: a meta-analysis. Int J Rheum Dis 21:2180–2187CrossRef
11.
Zurück zum Zitat Yuksel M, Yildiz A, Oylumlu M, Turkcu FM, Bilik MZ, Ekinci A, Elbey B, Tekbas E, Alan S (2016) Novel markers of endothelial dysfunction and inflammation in Behcet's disease patients with ocular involvement: epicardial fat thickness, carotid intima media thickness, serum ADMA level, and neutrophil-to-lymphocyte ratio. Clin Rheumatol 35:701–708CrossRef Yuksel M, Yildiz A, Oylumlu M, Turkcu FM, Bilik MZ, Ekinci A, Elbey B, Tekbas E, Alan S (2016) Novel markers of endothelial dysfunction and inflammation in Behcet's disease patients with ocular involvement: epicardial fat thickness, carotid intima media thickness, serum ADMA level, and neutrophil-to-lymphocyte ratio. Clin Rheumatol 35:701–708CrossRef
12.
Zurück zum Zitat (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 28:338–347 (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 28:338–347
13.
Zurück zum Zitat Lawton G, Bhakta BB, Chamberlain MA, Tennant A (2004) The Behcet's disease activity index. Rheumatology (Oxford) 43:73–78CrossRef Lawton G, Bhakta BB, Chamberlain MA, Tennant A (2004) The Behcet's disease activity index. Rheumatology (Oxford) 43:73–78CrossRef
14.
Zurück zum Zitat Bhakta BB, Brennan P, James TE, Chamberlain MA, Noble BA, Silman AJ (1999) Behcet's disease: evaluation of a new instrument to measure clinical activity. Rheumatology (Oxford) 38:728–733CrossRef Bhakta BB, Brennan P, James TE, Chamberlain MA, Noble BA, Silman AJ (1999) Behcet's disease: evaluation of a new instrument to measure clinical activity. Rheumatology (Oxford) 38:728–733CrossRef
15.
Zurück zum Zitat Akdeniz N, Elmas OF, Karadag AS (2019) Behcet syndrome: a great imitator. Clin Dermatol 37:227–239CrossRef Akdeniz N, Elmas OF, Karadag AS (2019) Behcet syndrome: a great imitator. Clin Dermatol 37:227–239CrossRef
16.
Zurück zum Zitat Akkoc N (2018) Update on the epidemiology, risk factors and disease outcomes of Behcet's disease. Best Pract Res Clin Rheumatol 32:261–270CrossRef Akkoc N (2018) Update on the epidemiology, risk factors and disease outcomes of Behcet's disease. Best Pract Res Clin Rheumatol 32:261–270CrossRef
17.
Zurück zum Zitat Esatoglu SN, Hatemi I, Ozguler Y, Hatemi G, Uzun H, Celik AF, Yazici H (2018) Faecal but not serum calprotectin levels look promising in predicting active disease in Behcet's syndrome patients with gastrointestinal involvement. Clin Exp Rheumatol 36:90–96PubMed Esatoglu SN, Hatemi I, Ozguler Y, Hatemi G, Uzun H, Celik AF, Yazici H (2018) Faecal but not serum calprotectin levels look promising in predicting active disease in Behcet's syndrome patients with gastrointestinal involvement. Clin Exp Rheumatol 36:90–96PubMed
18.
Zurück zum Zitat Bolek EC, Sari A, Kilic L, Kalyoncu U, Kurne A et al (2019) Clinical features and disease course of neurological involvement in Behcet's disease: HUVAC experience. Mult Scler Relat Disord 38:101512CrossRef Bolek EC, Sari A, Kilic L, Kalyoncu U, Kurne A et al (2019) Clinical features and disease course of neurological involvement in Behcet's disease: HUVAC experience. Mult Scler Relat Disord 38:101512CrossRef
19.
Zurück zum Zitat Ozyazgan Y, Ucar D, Hatemi G, Yazici Y (2015) Ocular involvement of Behcet's syndrome: a comprehensive review. Clin Rev Allergy Immunol 49:298–306CrossRef Ozyazgan Y, Ucar D, Hatemi G, Yazici Y (2015) Ocular involvement of Behcet's syndrome: a comprehensive review. Clin Rev Allergy Immunol 49:298–306CrossRef
20.
Zurück zum Zitat Yazici H, Tuzun Y, Pazarli H, Yurdakul S, Ozyazgan Y, Ozdogan H, Serdaroglu S, Ersanli M, Ulku BY, Muftuoglu AU (1984) Influence of age of onset and patient's sex on the prevalence and severity of manifestations of Behcet's syndrome. Ann Rheum Dis 43:783–789CrossRef Yazici H, Tuzun Y, Pazarli H, Yurdakul S, Ozyazgan Y, Ozdogan H, Serdaroglu S, Ersanli M, Ulku BY, Muftuoglu AU (1984) Influence of age of onset and patient's sex on the prevalence and severity of manifestations of Behcet's syndrome. Ann Rheum Dis 43:783–789CrossRef
21.
Zurück zum Zitat Jiang Y, Zang M, Li S (2017) Serum PLR and LMR in Behcet's disease: can they show the disease activity? Medicine (Baltimore) 96:e6981CrossRef Jiang Y, Zang M, Li S (2017) Serum PLR and LMR in Behcet's disease: can they show the disease activity? Medicine (Baltimore) 96:e6981CrossRef
23.
Zurück zum Zitat Erre GL, Paliogiannis P, Castagna F, Mangoni AA, Carru C, Passiu G, Zinellu A (2019) Meta-analysis of neutrophil-to-lymphocyte and platelet-to-lymphocyte ratio in rheumatoid arthritis. Eur J Clin Investig 49:e13037CrossRef Erre GL, Paliogiannis P, Castagna F, Mangoni AA, Carru C, Passiu G, Zinellu A (2019) Meta-analysis of neutrophil-to-lymphocyte and platelet-to-lymphocyte ratio in rheumatoid arthritis. Eur J Clin Investig 49:e13037CrossRef
24.
Zurück zum Zitat Kim HA, Jung JY, Suh CH (2017) Usefulness of neutrophil-to-lymphocyte ratio as a biomarker for diagnosing infections in patients with systemic lupus erythematosus. Clin Rheumatol 36:2479–2485CrossRef Kim HA, Jung JY, Suh CH (2017) Usefulness of neutrophil-to-lymphocyte ratio as a biomarker for diagnosing infections in patients with systemic lupus erythematosus. Clin Rheumatol 36:2479–2485CrossRef
25.
Zurück zum Zitat Kwon OC, Lee JS, Ghang B, Kim YG, Lee CK, Yoo B, Hong S (2018) Predicting eventual development of lupus nephritis at the time of diagnosis of systemic lupus erythematosus. Semin Arthritis Rheum 48:462–466CrossRef Kwon OC, Lee JS, Ghang B, Kim YG, Lee CK, Yoo B, Hong S (2018) Predicting eventual development of lupus nephritis at the time of diagnosis of systemic lupus erythematosus. Semin Arthritis Rheum 48:462–466CrossRef
Metadaten
Titel
Risk factors of disease activity in patients with Behçet’s syndrome
verfasst von
Cheng-cheng Hou
Jian-long Guan
Publikationsdatum
12.09.2020
Verlag
Springer International Publishing
Erschienen in
Clinical Rheumatology / Ausgabe 4/2021
Print ISSN: 0770-3198
Elektronische ISSN: 1434-9949
DOI
https://doi.org/10.1007/s10067-020-05386-9

Weitere Artikel der Ausgabe 4/2021

Clinical Rheumatology 4/2021 Zur Ausgabe

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag

RAS-Blocker bei Hyperkaliämie möglichst nicht sofort absetzen

14.05.2024 Hyperkaliämie Nachrichten

Bei ausgeprägter Nierenfunktionsstörung steigen unter der Einnahme von Renin-Angiotensin-System(RAS)-Hemmstoffen nicht selten die Serumkaliumspiegel. Was in diesem Fall zu tun ist, erklärte Prof. Jürgen Floege beim diesjährigen Allgemeinmedizin-Update-Seminar.

Gestationsdiabetes: In der zweiten Schwangerschaft folgenreicher als in der ersten

13.05.2024 Gestationsdiabetes Nachrichten

Das Risiko, nach einem Gestationsdiabetes einen Typ-2-Diabetes zu entwickeln, hängt nicht nur von der Zahl, sondern auch von der Reihenfolge der betroffenen Schwangerschaften ab.

Labor, CT-Anthropometrie zeigen Risiko für Pankreaskrebs

13.05.2024 Pankreaskarzinom Nachrichten

Gerade bei aggressiven Malignomen wie dem duktalen Adenokarzinom des Pankreas könnte Früherkennung die Therapiechancen verbessern. Noch jedoch klafft hier eine Lücke. Ein Studienteam hat einen Weg gesucht, sie zu schließen.

Battle of Experts: Sport vs. Spritze bei Adipositas und Typ-2-Diabetes

11.05.2024 DDG-Jahrestagung 2024 Kongressbericht

Im Battle of Experts traten zwei Experten auf dem Diabeteskongress gegeneinander an: Die eine vertrat die Auffassung „Sport statt Spritze“ bei Adipositas und Typ-2-Diabetes, der andere forderte „Spritze statt Sport!“ Am Ende waren sie sich aber einig: Die Kombination aus beidem erzielt die besten Ergebnisse.

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.