Behcet’s disease is a rare, chronic disorder involving inflammation of blood vessels throughout the body. It is marked by recurrent oral and genital ulcers and eye inflammation.
Causes
The cause of Behcet’s disease is unknown. It is believed to be caused by an autoimmune reaction. This occurs when the body’s immune system attacks its own tissue by mistake. This autoimmune abnormality may be inherited. An environmental trigger, such as a specific virus or bacterium, may activate the disease in people susceptible to it.
Risk Factors
A risk factor is something that increases your chances of getting a disease or condition. Although the exact cause of Behcet’s disease is unknown, some groups of people are more likely to develop the condition than others. Risk factors include:
Location: the Middle East, Asia, and Japan
Sex:
In the US, men are more likely than women to develop this condition.
In the Middle East, Asia, and Japan, women are more likely than men to develop Behcet’s.
Age: 20s and 30s
Symptoms
Symptoms of Behcet’s disease can vary from mild to very severe. Symptoms tend to appear, heal, and then recur (referred to as a flare) frequently over months or years. The most common symptoms of the disease are:
Causes ulcers and inflammation of the digestive tract (rarely)
Diagnosis
Diagnosing Behcet’s disease is very difficult because:
Symptoms are similar to those of many other diseases.
Symptoms often appear very slowly, over months or years.
There is no specific test to confirm the disease.
A doctor may suspect Behcet’s disease if oral sores appear at least three times within a year, and at least two of the following recurring symptoms appear:
Eye inflammation
Genital sores
Skin sores
If Behcet’s disease is suspected, your doctor will do tests to rule out other diseases with similar symptoms. Also, you may have a pathergy skin test. For this test, your skin is pricked with a small needle. If you have Behcet’s disease, a bump will develop at the site of the skin prick. However, this test is not conclusive. Many people with the disease do not have a reaction to the skin prick.
Treatment
There is no cure for Behcet’s disease. Treatment is aimed at limiting and preventing complications from symptoms. With proper treatment, the disease can usually be managed fairly well. Treatment includes medications, rest, and exercise.
Medication
Both topical and oral medications are used.
Topical medications include creams, lotions, and mouth rinses that contain corticosteroids (to cut down on inflammation) and/or anesthetics (to decrease pain). These are applied to sores to reduce inflammation and pain.
Oral medications, include:
Oral corticosteroids—to reduce inflammation and pain
Immunosuppressive drugs—to help control the overactive immune system. These may include:
Interferon
Azathioprine
Chlorambucil
Cyclosporine
Colchicine
Methotrexate
Dapsone
Infliximab
Thalidomide
Many of the drugs used to treat Behcet’s disease can cause severe side effects. If you are taking these medications your doctor must closely monitor you.
Rest and Exercise
General guidelines include:
Rest when symptoms flare to help speed healing.
Engage in moderate exercise when symptoms recede to help keep joints flexible and strong.
Prevention
There are no guidelines for the prevention of Behcet's disease because the exact cause is unknown.
RESOURCES:
American Behcet’s Disease Association http://www.behcets.com
National Institute of Arthritis and Musculoskeletal and Skin Diseases http://www.niams.nih.gov
CANADIAN RESOURCES:
BC Health Guide http://www.bchealthguide.org/
The Arthritis Society http://www.arthritis.ca/custom%20home/default.asp?s=1
References:
Abu El Asrar, ABoooud EB, ALbibhi H, Al-Arfaj A. Long-term safety and efficacy of infliximab therapy in refractory uveitis due to Behcet's disease.
Int Ophthalmol
. Sep 23, 2006.
Cakir O, Eren N, Ulka R, Nazaroghi H. Bilateral subclavian arterial aneurysm and ruptured abdominal aorta pseudoaneurysm in Behcet's disease.
Ann Vasc Surg.
2002,16:516-520
The Medical Letter. 1996;38:15.
The Merck Manual of Diagnosis and Therapy
. Simon & Schuster; 2001.
National Organization of Rare Disorders, Inc. website. Available at:
http://www.rarediseases.org/
.
National Institute of Arthritis and Musculoskeletal and Skin Diseases website. Available at:
http://www.niams.nih.gov
.
Okada AA. Behcet's disease: general concepts and recent advances.
Curr Opin Ophthalmol
. 2006;17:551-556.
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
