Behcet's Disease

Question 1

What is Behcet’s syndrome

Answer 1

complex, multisystem inflammatory disorder of the arteries and veins.

presumed to be autoimmune mediated

Question 2

What is the classical triad associated with Behcet’s?

Answer 2

1. oral ulcers
2. genital ulcers
3. anterior uveitis

Question 3

Who does Behcet’s commonly affect?

Answer 3

eastern meidterrenean e.g Turkey

more common and severe in men

young adults - 20-40yrs old

30% have a family hstory

Question 4

Which gene is Behcet’s associated with?

Answer 4

HLA B51

Question 5

Other than the triad associated with Behcet’s, what are other key features?

Answer 5

Veins - Thrombophlebitis and deep vein thrombosis

Skin: erythema nodosum, papules and pustules

MSK: oligoarthritis of large jounts, non erosive. and arthralgia

GI: colitis

Neuro: aseptic meningitis, pyramidal signs

Question 6

How do you diagnose Behcet’s

Answer 6

no definitive test

diagnosis based on clinical findings

positive pathergy test is suggestive (puncture site following needle prick becomes inflamed with small pustule forming within 48hrs)

Question 7

What is the management of Behcet’s disease?

Answer 7

co-ordinated by specialist - usually rheumatologist

• topical oral steroids e.g soluble betamethasone
• steroids e.g prednisolone
• colchicine for orogentical ulcers
• topical anaesthetics for genital ulcers e.g lidnocaine
• immunosuppresants e.g azathioprine
• biologics e.g infliximab

Question 8

What is the prognosis of Behcet’s

Answer 8

relapsing remitting
may go to complete remission
increased mortality from haemoptysis, neuro involvement, other major complications