Characterization of the diagnostic criteria for Behcet’s disease

Abstract

Aim. To present the diagnostic criteria for Behcet’s disease and its frequency in the structure of systemic vasculitis.
Materials and methods. The material for the study was the medical documentation of n=101 patients with suspected BD who were referred to the rheumatology department of the NMC “Shifobakhsh” for the period of 2017-2022. Information was collected on the speciality of the referring physician, and demographic data were recorded, including age, gender, and ethnicity. A complete history of current symptoms was obtained, which included the type, severity, and duration of symptoms, as well as a family history of BD. Subsequently, all patients were examined by a group of multidisciplinary experts, including rheumatologists, dermatologists and ophthalmologists. All patients underwent the Pathergy test.
Results. Of the total list of referred patients, 54 (53.5%) were women, and 47 (46.5%) were men. General practitioners were the most common speciality of attending physicians (33.7%) referring patients with suspected BD, followed by dentists (18.8%), ophthalmologists (16.8%) and rheumatologists 12.9%. The most common symptom referred for was oral lesions in 85.1%, followed by eye lesions in 31.7% and genital lesions in 22.8%. Out of 101 patients, 42.6% were diagnosed with BD, 18.8% had a probable diagnosis, and in 38.6% of patients, BD was ruled out. In patients who did not receive a diagnosis of BD, simple aphthous lesions were most common in 23.1%, followed by lichen planus in 4 (10.3%) and isolated eye involvement in 3 (7.7%).
Conclusion. BD can mimic several other disease processes as it manifests itself through non-specific changes in several organ systems. A constellation of findings put together eventually leads to a diagnosis. The results of this study can be used by rheumatologists who deal daily with patients with a high probability of BD and atypical manifestations. However, the alternative diagnoses established in this study can be used as a list of the most common differential diagnoses for systemic vasculitis.