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THU0628 (2018)
Differences in clinical manifestations of behcet’s syndrome by gender: cross-sectional analysis in a uk cohort
L. Chadwick1, T. Blake2, N.J. Goodson1, D. Situnayake2, R.J. Moots1
1Behcet’s Syndrome Centre of Excellence, Aintree University Hospital NHS Foundation Trust, Liverpool
2Behcet’s Syndrome Centre of Excellence, Sandwell and West Birmingham NHS Foundation Trust, Birmingham, UK

 

Background: Geographical variations in genotype and phenotype of Behçet’s syndrome (BS) are reported.1,2 Previous meta-analysis of international cohorts has highlighted differences in clinical manifestations of BS by gender.3 A comparison of BS clinical manifestations by gender has not been analysed previously in a large UK BS cohort.

Objectives: 1) To compare the clinical manifestations of BS in a UK cohort by gender and 2) to compare this to published international data.

Methods: A retrospective cross sectional analysis was performed using clinical databases at the Liverpool and Birmingham BS Centres of Excellence. Patients with a multi-disciplinary diagnosis of BS or International Study Group (ISG) diagnostic criteria were included. Clinical manifestations and HLA-B51 positivity were compared by gender. T-tests and chi-squared tests were used for continuous and categorical data respectively and a p value of 0.05 or less was considered statistically significant.

Results: 433 patients met inclusion criteria (140 males, 32.3%). Male patients were younger and had significantly higher rates of ocular and vascular involvement, papulopustular skin rash and HLA-B51 positivity. Female patients had significantly higher rates of genital aphthosis and arthralgia.

Male (n=140)

Female (n=293)

p value

Age (years), mean (s.d.)*

41.2 (12.5)

44.1 (11.9)

0.02

Recurrent oral aphthosis, n (%)

139 (99.3)

291 (99.3)

0.97

Genital aphthosis, n (%)*

111 (79.3)

278 (94.9)

<0.01

Papulopustular skin rash, n (%)*

69 (49.3)

107 (36.5)

0.01

Erythema nodosum, n (%)

29 (20.7)

56 (19.1)

0.70

Skin aphthosis (n,%)

7 (5.0)

8 (2.7)

0.23

Uveitis, n (%)*

81 (57.9)

99 (33.8)

<0.01

Retinal vasculitis, n (%)*

39 (27.9)

36 (12.3)

<0.01

Central nervous system involvement, n (%)

16 (11.4)

20 (6.8)

0.11

Large vein thrombosis, n (%)*

22 (15.7)

19 (6.5)

<0.01

Arterial thrombosis or aneurysm, n (%)

4 (2.9)

7 (2.4)

0.77

Thrombophlebitis, n (%)*

10 (7.1)

5 (1.7)

<0.01

Gastro-intestinal involvement, n (%)

8 (5.7)

25 (8.5)

0.30

Arthralgia, n (%)*

68 (48.6)

180 (61.4)

0.01

Ethnicity (British or White), n (%)*

90 (64.3)
(n=126)

238 (85.9)
(n=277)

<0.01

HLA-B51 positive, n (%)*

14 (58.3)
(n=27)

9 (20.0)
(n=45)

<0.01

*statistically significant

Conclusions: Similar to published international cohorts, male patients with BS in the UK have higher rates of ocular and venous involvement, papulopustular skin rash and HLA-B51 positivity and lower rates of genital aphthosis and arthralgia in comparison to female patients. However, the extent to which these differences are attributable to ethnicity is unclear.

References:

  1. Leonardo NM, McNeil J. Behcet’s Disease: Is There Geographical Variation? A Review Far from the Silk Road. Int J Rheumatol 2015: 1–7. doi:10.1155/2015/945262
  2. Sibley C, Yazici Y, Tascilar K, Khan N, Bata Y, Yazici H, et al. Behçet syndrome manifestations and activity in the United States versus Turkey - a cross-sectional cohort comparison. J Rheumatol 2014;41:137984. doi:10.3899/jrheum.131227
  3. Bonitsis NG, Nguyen LBL, LaValley MP, Papoutsis N, Altenburg A, et al. Gender-specific differences in Adamantiades-Behçet’s disease manifestations: an analysis of the German registry and meta-analysis of data from the literature. Rheumatology (Oxford). 2015;54: 121–33. doi:10.1093/rheumatology/keu247

Disclosure of Interest: None declared

DOI: 10.1136/annrheumdis-2018-eular.3249


Citation: Ann Rheum Dis, volume 77, supplement Suppl, year 2018, page A510
Session: Other orphan diseases