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Xiong J, Peng Y, Yu S, Liu P, Huang B, Kang M, Shao Y, Wu R. Retinal and Conjunctival Vessels in the Diagnosis and Assessment of Behcet's Disease: A New Approach. Ophthalmic Surg Lasers Imaging Retina 2024; 55:13-21. [PMID: 38189804 DOI: 10.3928/23258160-20231107-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2024]
Abstract
BACKGROUND AND OBJECTIVE The study aimed to investigate the alterations of retinal and conjunctival vessels in patients with Behcet's disease (BD). PATIENTS AND METHODS In this case-control study, 17 patients (34 eyes) diagnosed with BD and 17 healthy volunteers (34 eyes) matched by age, sex, blood pressure, and intraocular pressure were recruited. Optical coherence tomography angiography examinations were performed to calculate the vessel density of the retina and conjunctiva according to different sizes of vessels and different zones divided by three segmentation methods of the retina: hemispheric segmentation, Early Treatment Diabetic Retinopathy Study, and central annulus segmentation. RESULTS The vessel densities of the superficial macrovascular (P = 0.050), superficial microvascular (P < 0.001), superficial total microvascular (P < 0.001), deep total microvascular (P < 0.001), and deep total microvascular (P < 0.001) were significantly lower in the BD group. The conjunctival vessel density was significantly higher in the BD group (P < 0.001). The receiver operating characteristic curve analysis showed that the area under the curve of vessel density of the superior right (0.993, 95% CI 0.980-1) and right zones (0.996, 95% CI 0.987-1) were the largest in the superficial and deep retina, respectively. Otherwise, the area under the curve of conjunctival vessel density was 0.728 (95% CI 0.607-0.848). CONCLUSIONS In patients with BD, retinal vessel density decreases, while conjunctival vessel density increases. Optical coherence tomography angiography provides a new noninvasive and quantitative assessment for retinal and conjunctival vessels. [Ophthalmic Surg Lasers Imaging Retina 2024;55:13-21.].
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Fan S, Shi X, Chen Z, Li X, Yu S, Li J. Retinal and choroidal microvascular alterations in Behcet’s disease without ocular manifestations: A systematic review and meta-analysis. Front Med (Lausanne) 2022; 9:911990. [PMID: 35935767 PMCID: PMC9353174 DOI: 10.3389/fmed.2022.911990] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2022] [Accepted: 07/05/2022] [Indexed: 12/12/2022] Open
Abstract
PurposeWe performed a systematic review and meta-analysis to examine the microvascular alterations in non-ocular Behcet’s disease (BD) using optical coherence tomography angiography (OCTA).MethodsA comprehensive search was performed in Pubmed, Embase and Cochrane databases for eligible studies from inception to February 2022. Detailed clinical demographics were extracted from each study by two independent reviewers. The weighted mean difference (WMD) and 95% confidence intervals (CI) were used to compare the OCTA parameters between non-ocular BD and healthy controls. Stata 12.0 was adopted to conduct statistical analyses.ResultsTen cross-sectional studies involving 386 eyes in non-ocular BD and 418 eyes in healthy volunteers were ultimately included in the present analysis. When considering superficial capillary plexus (SCP) and deep capillary plexus (DCP), no significant differences of vessel densities in the whole enface image, fovea and perifovea were evaluated between two groups. Significantly reduced parafoveal vessel density of SCP was observed in non-ocular BD in comparison with healthy group (WMD = −1.33, 95%CI: −1.78, −0.89; I2 = 0.6%), while slightly decreased parafoveal vessel density was assessed in DCP (WMD = −1.47, 95%CI: −3.30, 0.35; I2 = 89.3%). Significantly increasing foveal avascular zone (FAZ) area was observed in non-ocular BD when compared to healthy controls (WMD = 0.11, 95%CI: 0.03, 0.19; I2 = 95.3%). There was no significant difference in flow area of choriocapillaris between non-ocular BD and control group (WMD = 0.06, 95%CI: −0.19, 0.32; I2 = 0%).ConclusionBased on current analysis, our results demonstrated significantly lower parafoveal vessel density of SCP and lager FAZ area in full vasculature in non-ocular BD. The retinal microvascular alterations appear before the emergence of ocular manifestations.Systematic Trial Registration[https://www.crd.york.ac.uk/PROSPERO/], identifier [CRD42021244856].
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Affiliation(s)
- Shipei Fan
- Department of Ophthalmology, Lishui Municipal Central Hospital, The Fifth Affiliated Hospital of Wenzhou Medical University, Lishui, China
| | - Xingyu Shi
- Department of Nephrology, Lishui Municipal Central Hospital, The Fifth Affiliated Hospital of Wenzhou Medical University, Lishui, China
| | - Zhen Chen
- Department of Ophthalmology, Lishui Municipal Central Hospital, The Fifth Affiliated Hospital of Wenzhou Medical University, Lishui, China
| | - Xia Li
- Department of Ophthalmology, Lishui Municipal Central Hospital, The Fifth Affiliated Hospital of Wenzhou Medical University, Lishui, China
| | - Songping Yu
- Department of Ophthalmology, Lishui Municipal Central Hospital, The Fifth Affiliated Hospital of Wenzhou Medical University, Lishui, China
- *Correspondence: Songping Yu,
| | - Jun Li
- Department of Ophthalmology, Lishui Municipal Central Hospital, The Fifth Affiliated Hospital of Wenzhou Medical University, Lishui, China
- Jun Li,
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Faisal M, Matarneh A, Alshahwani I, Al-Allaf O, Al-Allaf AW. Neuromyelitis Optica Spectrum Disorder and Autoimmune Rheumatological Diseases: A Report of Two Cases and Literature Review. Cureus 2022; 14:e26138. [PMID: 35875295 PMCID: PMC9301260 DOI: 10.7759/cureus.26138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/20/2022] [Indexed: 11/26/2022] Open
Abstract
Neuromyelitis optica spectrum disorder (NMOSD) is a rare autoimmune disorder, and its association with other autoinflammatory diseases has been reported in this study. In this article, we are discussing two patients with neuromyelitis optica who show evidence of autoimmune rheumatic diseases. The first case presented with acute myelitis and was diagnosed with NMOSD; she developed clinical features of Behçet’s disease during follow-up, making it the second reported case worldwide. The second case presented with neuromyelitis optica and was found to have strongly positive Sjogren’s serology.
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Novak T, Hamedi M, Bergmeier LA, Fortune F, Hagi-Pavli E. Saliva and Serum Cytokine Profiles During Oral Ulceration in Behçet's Disease. Front Immunol 2022; 12:724900. [PMID: 35003055 PMCID: PMC8727526 DOI: 10.3389/fimmu.2021.724900] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Accepted: 10/22/2021] [Indexed: 12/31/2022] Open
Abstract
Behçet's disease (BD) is a chronic, multi-systemic disorder of unknown aetiology typified by recurrent oral and genital mucocutaneous lesions, uveitis and vasculitis. Innate and adaptive immune system dysregulation has been implicated in pathogenesis with alterations in serum cytokine profiles. Few studies have investigated salivary cytokines in BD, despite more than 90% of BD patients first presenting with oral ulceration. The aim of this pilot study was twofold; firstly to investigate whether cytokine levels in matched serum and saliva samples show a differential profile in BD (with and without oral ulcers), recurrent aphthous stomatitis (RAS) and healthy controls (HCs), and secondly, to explore if any differential profiles in serum and/or saliva could provide a panel of cytokines with diagnostic and therapeutic potential for BD. Concentrations of 12 cytokines (IL-1β, IL-2, IL-4, IL-5, IL-6, IL-8, IL-10, IL-12p70, IL-17A, IFN-γ, TNF-α, TNF-β) were measured using the Human Th1/Th2 11-Plex FlowCytomix™ kit with IL-17A, in BD (N=20), RAS (N=6) and HCs (N=10). A differential range of cytokines was detected in serum and saliva with the majority of cytokine levels higher in saliva. The most prevalent salivary cytokines were IL-1β, IL-2, IL-8, IL-10 and TNF-α present in all samples in contrast to serum where the most prevalent cytokine detected was IL-8 (91.9%). The least abundant cytokine was IFN-γ in both saliva (43.2%) and serum (2.7%). After normalizing saliva for protein content, BD patients with oral ulcers (BD-MA) had significantly higher levels of salivary IL-1β (p=0.01), IL-8 (p=0.02), TNF-α (p=0.004) and IL-6 (p=0.01) than HCs. Notably, BD patients without oral ulcers (BD-MQ) also had significantly higher salivary IL-1β, IL-8 and TNF-α (p ≤ 0.05) than HCs. During relapsed (BD-RE) and quiet (BD-Q) systemic episodes, salivary IL-β and TNF-α were also significantly increased with IL-8 significantly higher only in BD-Q (p=0.02). BD oral ulcers signify a potential reactivation of systemic inflammation. Identifying cytokines released during asymptomatic episodes and oral ulceration might lead to targeted drug therapy to prevent recurrent oral ulcers and possible disease relapse. This is the first study to report salivary cytokine levels in BD. The detectable levels suggests cytokine profiling of BD saliva may provide an alternative, less invasive, sensitive procedure for frequent monitoring of disease activity and progression.
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Affiliation(s)
- Tanya Novak
- Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital and Department of Anesthesia, Harvard Medical School, Boston, MA, United States
| | - Mojgan Hamedi
- Centre for Oral Immunobiology and Regenerative Medicine, Barts and The London School, of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
| | - Lesley Ann Bergmeier
- Centre for Oral Immunobiology and Regenerative Medicine, Barts and The London School, of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
| | - Farida Fortune
- Centre for Oral Immunobiology and Regenerative Medicine, Barts and The London School, of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
| | - Eleni Hagi-Pavli
- Centre for Oral Immunobiology and Regenerative Medicine, Barts and The London School, of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
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Hsieh MY, Lee TT, Yang JM, Chung HC. A Female Patient With a Urinary Tract Infection and Multiple Vaginal Ulcers. J Acute Med 2021; 11:153-157. [PMID: 35155093 PMCID: PMC8743194 DOI: 10.6705/j.jacme.202112_11(4).0006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Revised: 11/19/2020] [Accepted: 12/17/2020] [Indexed: 06/14/2023]
Abstract
This report is to describe a rare case of urinary tract infection (UTI) with multiple vaginal ulcers. In the report, the 45-year-old female patient was diagnosed with a UTI, but white blood cells and neutrophil are higher than reference value. A vaginal ultrasound was performed with a positive fi nding of uterine myoma and multiple painless vaginal ulcers in the vaginal wall. Also, elevated antinuclear antibodies were found. After treated with antibiotic, self-healed vaginal ulcers were observed even without topical ointment use for vaginal ulcers. In conclusion, UTIs are a common disease in females. This is a rare case of a UTI with multiple vaginal ulcers. Observation of the genital condition is necessary if a woman has a UTI. Treating the source of the UTI is necessary, and the vaginal ulcerations also require appropriate treatment and follow up.
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Affiliation(s)
- Min-Yi Hsieh
- Cardinal Tien Hospital Department of Emergency New Taipei City Taiwan
| | - Tzen-Tak Lee
- Cardinal Tien Hospital Department of Emergency New Taipei City Taiwan
| | - Jung-Mou Yang
- Cardinal Tien Hospital Department of Emergency New Taipei City Taiwan
| | - Hung-Chun Chung
- Cardinal Tien Hospital Department of Emergency New Taipei City Taiwan
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Pei M, Zhao C, Gao F, Qu Y, Liang A, Xiao J, Zhang M. Analysis of Parafoveal Microvascular Abnormalities in Behcet's Uveitis Using Projection-Resolved Optical Coherence Tomographic Angiography. Ocul Immunol Inflamm 2019; 29:524-529. [PMID: 31743043 DOI: 10.1080/09273948.2019.1685108] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Purpose: To assess the characteristics of parafoveal microvascular abnormalities in Behcet's uveitis (BDU) using projection-resolved optical coherence tomographic angiography (PR-OCTA).Methods: A retrospective study of BDU patients who underwent PR-OCTA examination between April 1, 2017 and October 31, 2018.Results: Sixty consecutive BDU patients (102 eyes) were included. Sixty-two (124 eyes) healthy subjects served as normal controls (NCs). As compared with NCs, the vessel densities (VDs) of superficial and deep retinal capillary plexuses were decreased, and the fovea avascular zone area, perimeter and acircularity index were increased in BDU eyes (all p < .001). Macular edema (p < .001) and long uveitis course (p = .033) were identified as risk factors for capillary disruptions. Consistent VD reductions were observed in the quiescent fellow eyes of BDU patients during unilateral uveitis relapse.Conclusions: BDU patients had significant OCTA changes. Macular circulatory disturbances may exist in the quiescent fellow eyes during unilateral BDU attack.
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Affiliation(s)
- Minghang Pei
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Chan Zhao
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Fei Gao
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yi Qu
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Anyi Liang
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Junyan Xiao
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Meifen Zhang
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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Gualtierotti R, Marzano AV, Spadari F, Cugno M. Main Oral Manifestations in Immune-Mediated and Inflammatory Rheumatic Diseases. J Clin Med 2018; 8:jcm8010021. [PMID: 30585183 PMCID: PMC6351952 DOI: 10.3390/jcm8010021] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2018] [Revised: 12/18/2018] [Accepted: 12/20/2018] [Indexed: 12/18/2022] Open
Abstract
Oral manifestations are frequent in patients with rheumatic diseases. The aim of this review is to offer readers practical advice concerning the onset, diagnosis and treatment of the main oral manifestations encountered in rheumatological and dental clinics. Signs and symptoms such as oral hyposalivation, xerostomia, temporomandibular joint disorders, periodontal disease, and dysphagia may be the first expression of a number of rheumatic diseases. Some of these manifestations are aspecific and very frequent, such as oral aphthosis, which can be the first manifestation in patients with systemic lupus erythematosus; some are potentially dangerous, such as jaw claudication during the course of giant cell arteritis; and some are very rare but peculiar, such as strawberry-like gingivitis in patients with granulomatosis with polyangiitis. Other oral manifestations are due to adverse reactions to disease-modifying anti-rheumatic drugs. Oral alterations in rheumatic diseases are frequently overlooked in clinical practice, but their prompt recognition not only allows the local lesions to be appropriately treated, but also makes it possible to identify an underlying systemic disease.
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Affiliation(s)
- Roberta Gualtierotti
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, 20122 Milano, Italy.
| | - Angelo Valerio Marzano
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Dermatology Unit, IRCCS Fondazione Ca' Granda, Ospedale Maggiore Policlinico, 20122 Milano, Italy.
| | - Francesco Spadari
- Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, 20122 Milano, Italy.
| | - Massimo Cugno
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Internal Medicine, IRCCS Fondazione Ca' Granda, Ospedale Maggiore Policlinico, 20122 Milano, Italy.
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8
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Porter SR, Mercadante V, Fedele S. Oral manifestations of systemic disease. Br Dent J 2018; 223:683-691. [PMID: 29123296 DOI: 10.1038/sj.bdj.2017.884] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/02/2017] [Indexed: 12/17/2022]
Abstract
While the majority of disorders of the mouth are centred upon the direct action of plaque, the oral tissues can be subject to change or damage as a consequence of disease that predominantly affects other body systems. Such oral manifestations of systemic disease can be highly variable in both frequency and presentation. As lifespan increases and medical care becomes ever more complex and effective it is likely that the numbers of individuals with oral manifestations of systemic disease will continue to rise. The present article provides a succinct review of oral manifestations of systemic disease. In view of this article being part of a wider BDJ themed issue on the subject of oral medicine, this review focuses upon oral mucosal and salivary gland disorders that may arise as a consequence of systemic disease.
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Affiliation(s)
- S R Porter
- UCL Eastman Dental Institute, 256 Gray's Inn Road, London, WC1X 8LD
| | - V Mercadante
- UCL Eastman Dental Institute, 256 Gray's Inn Road, London, WC1X 8LD
| | - S Fedele
- UCL Eastman Dental Institute, 256 Gray's Inn Road, London, WC1X 8LD.,UCL NIHR Biomedical Research Centre
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Yalçindağ F, YalçIndağ A, Çağlayan O, Özdemir Ö. Serum Haptoglobin Levels in Ocular Behçet Disease and Acute Phase Proteins in the Course of Behçet Disease. Eur J Ophthalmol 2018; 18:787-91. [DOI: 10.1177/112067210801800520] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose Changes in concentrations of acute phase proteins in the serum of patients might be significant in the pathogenesis of Behçet disease. This report investigates the association between ocular disease activity and serum haptoglobin levels in patients with Behçet disease, and summarizes the current understanding of the correlation between acute phase proteins and Behçet disease based on both personal studies and data from the literature. Methods Thirty patients with Behçet disease with ocular involvement and 15 healthy subjects were included in the study. Of the 30 patients, 14 had acute uveitis and 16 had inactive ocular involvement at the time of enrollment. Results There was a significant difference in haptoglobin levels between the patients with active ocular disease and controls (p=0.0005). There was also a significant difference in haptoglobin levels between the patients with inactive ocular disease and control subjects (p<0.0001). However, no significant difference was observed among patients with active versus inactive uveitis with regard to serum haptoglobin levels. Conclusions Higher serum haptoglobin levels in patients with Behçet disease compared to control subjects were obtained. However, elevated serum haptoglobin levels do not seem to be a risk factor for uveitis activity. Behçet disease is generally diagnosed by physical examinations and no laboratory marker has been widely accepted for follow-up of disease activity.
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Affiliation(s)
- F.N. Yalçindağ
- Department of Ophthalmology, Ankara University, Faculty of Medicine, Ankara
| | - A. YalçIndağ
- Department of Clinical Biochemistry, Kirikkale University, Faculty of Medicine, Kirikkale - Turkey
| | - O. Çağlayan
- Department of Clinical Biochemistry, Kirikkale University, Faculty of Medicine, Kirikkale - Turkey
| | - Ö. Özdemir
- Department of Ophthalmology, Ankara University, Faculty of Medicine, Ankara
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Tajima Y, Goto H, Ohara M, Hashimoto M, Akamatsu D, Shimizu T, Miyama N, Tsuchida K, Kawamura K, Umetsu M, Suzuki S, Ohuchi N. Oral Steroid Use and Abdominal Aortic Aneurysm Expansion ― Positive Association ―. Circ J 2017; 81:1774-1782. [DOI: 10.1253/circj.cj-16-0902] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Yuta Tajima
- Department of Transplantation, Reconstruction and Endoscopic Surgery, Tohoku University Hospital
| | - Hitoshi Goto
- Department of Transplantation, Reconstruction and Endoscopic Surgery, Tohoku University Hospital
| | - Masato Ohara
- Department of Transplantation, Reconstruction and Endoscopic Surgery, Tohoku University Hospital
| | - Munetaka Hashimoto
- Department of Transplantation, Reconstruction and Endoscopic Surgery, Tohoku University Hospital
| | - Daijiro Akamatsu
- Department of Transplantation, Reconstruction and Endoscopic Surgery, Tohoku University Hospital
| | - Takuya Shimizu
- Department of Vascular Surgery, Japanese Red Cross Ishinomaki Hospital
| | - Noriyuki Miyama
- Department of Transplantation, Reconstruction and Endoscopic Surgery, Tohoku University Hospital
- Department of Vascular Surgery, Kansai Medical University Medical Center
| | - Ken Tsuchida
- Department of Transplantation, Reconstruction and Endoscopic Surgery, Tohoku University Hospital
| | - Keiichiro Kawamura
- Department of Vascular Surgery, Japan Community Health Care Organization Sendai Hospital
| | - Michihisa Umetsu
- Department of Transplantation, Reconstruction and Endoscopic Surgery, Tohoku University Hospital
| | - Shunya Suzuki
- Department of Transplantation, Reconstruction and Endoscopic Surgery, Tohoku University Hospital
| | - Noriaki Ohuchi
- Department of Transplantation, Reconstruction and Endoscopic Surgery, Tohoku University Hospital
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Elbay AE, Topalkara A, Elbay A, Erdoğan H, Vural A, Bahadır Çetin A. Evaluation of Serum Homocysteine and Leptin Levels in Patients with Uveitis. Turk J Ophthalmol 2015; 45:146-151. [PMID: 27800222 PMCID: PMC5082272 DOI: 10.4274/tjo.26539] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2014] [Accepted: 12/02/2014] [Indexed: 12/01/2022] Open
Abstract
OBJECTIVES To evaluate the serum homocysteine (Hcy) and leptin levels in patients with uveitis. MATERIALS AND METHODS The 70 cases included in the study comprised 3 groups: patients with Behçet's uveitis (BU), patients with non-Behçet's uveitis (NBU) and healthy controls. Body mass index was calculated for each subject. Serum Hcy and leptin levels were measured. Furthermore, acute-phase reactants including erythrocyte sedimentation rate (ESR), C-reactive protein and neutrophil count were measured. RESULTS Serum Hcy levels were 15.04±4.59 µmol/L in the BU group, 15.4±6.87 µmol/L in the NBU group and 13.64±4.72 µmol/L in the control group (p>0.05). The serum leptin levels of male patients in the BU group, NBU group and control group were 4.76±3.54 ng/ml, 6.33±3.74 ng/ml and 5.47±6.33 ng/ml, respectively (p>0.05). When we compared serum leptin levels in female patients and controls, the mean serum leptin concentrations were significantly higher in female BU and NBU patients (24.83±17.62 ng/ml and 28.46±13.90 ng/ml, respectively) than in healthy control volunteers (9.62±6.36 ng/ml, p<0.05). In addition, the ESR value differences between groups were statistically significant (p<0.05). CONCLUSION A larger case series is necessary to investigate serum Hcy and leptin concentrations in uveitis patients.
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Affiliation(s)
- Arif Emre Elbay
- Gazi State Hospital, Clinic of Ophthalmology, Samsun, Turkey
| | - Ayşen Topalkara
- Cumhuriyet University Faculty of Medicine, Department of Ophthalmology, Sivas, Turkey
| | - Ahmet Elbay
- Pendik State Hospital, Clinic of Ophthalmology, İstanbul, Turkey
| | - Haydar Erdoğan
- Cumhuriyet University Faculty of Medicine, Department of Ophthalmology, Sivas, Turkey
| | - Ayşe Vural
- Cumhuriyet University Faculty of Medicine, Department of Ophthalmology, Sivas, Turkey
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Abstract
Behçet's disease (BD) is a relapsing, systemic, inflammatory disorder that affects various organ systems. Most of the manifestations of BD are self-limiting, but ocular attacks are an exception. Gastrointestinal tract, central nervous system, and cardiovascular system manifestations are relatively infrequent but may be resistant to conventional immunosuppressive treatment and therefore life-threatening. Tumor necrosis factor alpha antagonists are increasingly being used in patients whose BD is inadequately controlled by standard immunosuppressive regimens. Most of the current experience regarding the treatment of refractory BD involves the use of infliximab; however, adalimumab has also been successfully used in cases of BD refractory to both conventional therapy and infliximab. Compared with infliximab, adalimumab offers several other advantages, such as the ability to self-administer at home, better patient compliance, and an improved side effect profile. Here, we review clinical experience of the use of adalimumab to treat the serious manifestations of BD. Adalimumab is a promising drug for the treatment of BD, and its randomized, prospective study in a large number of patients is warranted to fully determine its efficacy in the refractory BD setting.
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Affiliation(s)
- Atsuhisa Ueda
- Department of Internal Medicine and Clinical Immunology, Graduate School of Medicine, Yokohama City University, Yokohama, Japan
| | - Mitsuhiro Takeno
- Department of Internal Medicine and Clinical Immunology, Graduate School of Medicine, Yokohama City University, Yokohama, Japan
| | - Yoshiaki Ishigatsubo
- Department of Internal Medicine and Clinical Immunology, Graduate School of Medicine, Yokohama City University, Yokohama, Japan
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13
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Zhao H, He B, Shen X, Qiao Z, Xu T, Lian F, Xue S. Aortic root dissection with left valsalva sinus perforation detected by transesophageal 3D echocardiography in a patient with Behçet's disease. JOURNAL OF CLINICAL ULTRASOUND : JCU 2014; 42:59-62. [PMID: 23315824 DOI: 10.1002/jcu.22028] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/01/2010] [Accepted: 06/01/2011] [Indexed: 06/01/2023]
Abstract
Behçet's disease (BD) is a multi-system inflammatory disorder. We report the case of a BD patient with severe aortic root vasculitis. Two-dimensional transthoracic echocardiography (2DE) images suggested left Valsalva sinus aneurysm ruptured into the left ventricular outflow tract. However, preoperative transesophageal real-time 3-dimensional echocardiography (3DE) revealed that the aneurysm-like structure involved most of the left ventricular outflow tract wall, leading to the diagnosis of aortic root dissection associated with perforation of the left Valsalva sinus and prolapse of the exfoliated endocardium into the left ventricular outflow tract. These findings were confirmed by open heart surgery. 3DE was helpful differentiating aortic root dissection from Valsalva sinus aneurysm rupture, especially by demonstrating the extent of aneurysm-like structure in the left ventricular outflow tract.
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Affiliation(s)
- Hang Zhao
- Cardiology Department, Renji Hospital, Medical College of Shanghai Jiao-Tong University, Shanghai 200127, China
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Maldini C, Lavalley MP, Cheminant M, de Menthon M, Mahr A. Relationships of HLA-B51 or B5 genotype with Behcet's disease clinical characteristics: systematic review and meta-analyses of observational studies. Rheumatology (Oxford) 2012; 51:887-900. [PMID: 22240504 DOI: 10.1093/rheumatology/ker428] [Citation(s) in RCA: 135] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVE To investigate comprehensively the relationships between Behçet's disease (BD) clinical features and HLA-B51 or HLA-B5 (HLA-B51/B5) status using meta-analyses. METHODS Relevant publications were identified by a systematic literature search. Eligible studies had to provide frequencies for one or more BD characteristics according to HLA-B51/B5 status. Pooled relative risks (RRs) were calculated by random-effects meta-analysis for those BD characteristics for which five or more relevant studies were identified. Between-study variability was assessed with I(2) and Q-statistics, and modelled using meta-regression. RESULTS Among the 859 publications evaluated, 72 (representing 74 study populations) met eligibility criteria. Pooled RRs (95% CIs) of the association of HLA-B51/B5 with the 14 analysed clinical characteristics were male sex 1.14 (1.05, 1.23); eye involvement 1.13 (1.06, 1.21); genital ulcers 1.07 (1.01, 1.14); skin involvement 1.10 (1.03, 1.16); erythema nodosum 1.11 (0.96, 1.29); pseudofolliculitis 1.07 (0.93, 1.23); positive pathergy test 1.05 (0.94, 1.17); joint involvement 0.94 (0.86, 1.04); neurological involvement 0.95 (0.71, 1.27); gastrointestinal involvement 0.70 (0.52, 0.94); thrombophlebitis 1.17 (0.77, 1.76); vascular involvement 1.00 (0.68, 1.47); chest involvement 1.55 (0.75, 3.20) and orchiepididymitis 1.13 (0.59, 2.15). For most of the analysed outcomes, between-study heterogeneity was low or absent and most of the meta-regression models were statistically non-significant. CONCLUSION The results of these meta-analyses showed that, in BD, HLA-B51/B5 carriage predominates in males and is associated with moderately higher prevalences of genital ulcers, ocular and skin manifestations, and a decreased prevalence of gastrointestinal involvement.
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Affiliation(s)
- Carla Maldini
- Department of Internal Medicine, Hospital Saint-Louis, 1 avenue Claude-Vellefaux, 75475 Paris Cedex 10, France
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Abstract
Behçet's disease is a chronic relapsing multisystemic inflammatory disorder characterized by four major symptoms (oral aphthous ulcers, genital ulcers, skin lesions, and ocular lesions) and occasionally by five minor symptoms (arthritis, gastrointestinal ulcers, epididymitis, vascular lesions, and central nervous system symptoms). Although the etiology of Behçet's disease is still unknown, there have been recent advances in immunopathogenic studies, genome-wide association studies, animal models, diagnostic markers, and new biological agents. These advances have improved the clinical understanding of Behçet's disease and have enabled us to develop new treatment strategies for this intractable disease, which remains one of the leading causes of blindness.
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Affiliation(s)
- Sung Bin Cho
- Department of Dermatology and Cutaneous Biology Research Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Suhyun Cho
- Department of Dermatology and Cutaneous Biology Research Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Dongsik Bang
- Department of Dermatology and Cutaneous Biology Research Institute, Yonsei University College of Medicine, Seoul, Korea
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Özdemir S, Özdemir M, Celik C, Balevi A, Toy H, Kamış U. Evaluation of patients with Behçet's disease by cervical cytology and colposcopic examination. Arch Gynecol Obstet 2011; 285:1363-8. [PMID: 22159744 DOI: 10.1007/s00404-011-2158-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2011] [Accepted: 11/23/2011] [Indexed: 10/14/2022]
Abstract
PURPOSE We evaluated the genital involvement in women with Behçet's disease (BD) by cervical cytology and colposcopy, and compared these findings with healthy controls. METHODS A total of 152 women were referred to the Gynecology Clinic of Meram School of Medicine between March 2008 and December 2009. The study group was composed of 78 women with BD, and the control group included 74 healthy women admitted for routine gynecologic examination. These patients were subjected to cervical cytology and colposcopic examination. Cervical biopsy was performed in cases with abnormal cytology. These findings and some gynecologic complaints were compared. RESULTS The demographic features were similar between each group. Genital involvement (scar + ulcer) was detected in 58 (74.3%) patients. The most common sites of ulcers (55.1%) and scars (7.6%) were the labia majora. Abnormal cytology in study and control groups was detected in nine (11.5%) and three (4%) of the patients, respectively, and a slight statistical significance was obtained (p = 0.048). Acetowhite and iodine-negative epithelium were higher in the study group than in controls (p = 0.015 and p = 0.042). Dyspareunia was higher in BD patients (p = 0.001). CONCLUSION Patients with BD are more prone to having an abnormal cervical cytology and acetowhite and iodine-negative epithelium on colposcopic examination. However, these findings are mostly benign conditions. The complaint of dyspareunia should be considered during treatment of female patients with BD.
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Affiliation(s)
- Suna Özdemir
- Department of Obstetrics and Gynecology, School of Medicine, Bezmialem Vakif University, 34093 Fatih, Istanbul, Turkey.
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The Quality of Life in Patients With Behçet’s Disease. Asian Nurs Res (Korean Soc Nurs Sci) 2011; 5:229-35. [DOI: 10.1016/j.anr.2011.12.003] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2011] [Revised: 11/26/2011] [Accepted: 11/28/2011] [Indexed: 11/18/2022] Open
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Şahin E, Karaman G, Uslu M, Karul A, Şendur N, Şavk E. Adiponectin levels, insulin resistance and their relationship with serum levels of inflammatory cytokines in patients with Behçet's disease. J Eur Acad Dermatol Venereol 2011; 26:1498-502. [PMID: 22035239 DOI: 10.1111/j.1468-3083.2011.04318.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
AIM Increased frequency of cardiovascular disease and its possible relations with insulin resistance have been reported in patients with inflammatory diseases. The aim of our study was to investigate insulin resistance and serum adiponectin levels as cardiovascular risk markers in patients with Behçet's disease. METHOD Study population consisted of 40 patients with Behçet's disease (BD) and a control group composed of age, gender, body mass index-matched 46 healthy individuals. All patients were examined for signs of Behçet's disease. Body mass index, waist and hip circumference were measured. Insulin resistance was evaluated using the homeostasis model assessment-insulin resistance method. Erythrocyte sedimentation rate (ESR), lipid profile, high sensitive CRP (hsCRP), adiponectin, TNF-α, IL-6 and IL-8 levels were measured. RESULTS Erythrocyte sedimentation rate, serum hsCRP and IL-6 levels were significantly higher in patients with BD than those in the controls (P=0.001, P=0.001, P=0.001, respectively). Fasting plasma glucose, insulin levels and lipid profile were not different between the two groups. Insulin resistance and decreased levels of the serum adiponectin were not detected in the patients. There was no relationship between insulin resistance, adiponectin levels and inflammatory markers. Active and inactive patients did not differ in respect of any parameters. CONCLUSION Being a systemic vasculitis, BD may cause cardiovascular involvement. In this study, dyslipidemia, insulin resistance and low adiponectin levels were not detected among our patients with Behçet's disease. Our results suggest that there exists no increased risk for atherosclerotic cardiovascular disease associated with adiponectin levels and insulin resistance in patients with Behçet's disease.
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Affiliation(s)
- E Şahin
- Özel Yüzüncü Yıl Hospital, Ankara, Turkey
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Küçükkolbaşi H, Küçükkolbaşi S, Dursun R, Ayyildiz F, Kara H. Determination of defensin HNP-1 in human saliva of patients with oral mucosal diseases. J Immunoassay Immunochem 2011; 32:284-95. [PMID: 21728821 DOI: 10.1080/15321819.2011.569045] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Saliva is a biological fluid that is easily obtainable and that can give useful information both in systemic and oral diseases. In this study, a chromatographic method was applied to determine the amount of defensin HNP-1 in human saliva of patients with oral mucosal diseases before and after treatments and compared with controls. Defensin human neutrophil peptide-1 (HNP-1) was identified and confirmed. The concentration of HNP-1 in saliva was determined by comparing the area of eluted HNP-1 with that of HNP-1 standard. Linear calibration range of defensin HNP-1 was 0.10 to 0.90 μg/10 μL with R(2) values of 0.996. The concentrations of HNP-1 in the saliva of patients with oral lichen planus, Behçet's disease, and recurrent apthous stomatitis were 33.6 ± 10.6, 15.5 ± 7.6, and 36.3 ± 9.5 μg mL(-1) (mean ± S.D.), respectively. The salivary defensin-1 concentration was significantly higher in patients with oral mucosal diseases than in healthy volunteers; furthermore, in patients with oral mucosal diseases, the concentration was significantly higher before treatment than after treatment.
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Affiliation(s)
- Hasan Küçükkolbaşi
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Selcuk University, Konya, Turkey
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Han EC, Cho SB, Ahn KJ, Oh SH, Kim J, Kim DS, Lee KH, Bang D. Expression of Pro-inflammatory Protein S100A12 (EN-RAGE) in Behçet's Disease and Its Association with Disease Activity: A Pilot Study. Ann Dermatol 2011; 23:313-20. [PMID: 21909201 PMCID: PMC3162260 DOI: 10.5021/ad.2011.23.3.313] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2010] [Revised: 02/25/2011] [Accepted: 03/23/2011] [Indexed: 12/02/2022] Open
Abstract
Background S100A12 is a member of the S100 family of calcium-binding proteins and is secreted either in inflamed tissues or in the bloodstream by activated neutrophils. Expression of S100A12 has been reported in various diseases, especially non-infectious inflammatory diseases, such as Kawasaki disease, giant cell arteritis and inflammatory bowel disease. Objective This study was conducted to determine both the tissue expression and the serum levels of S100A12 in Behçet's disease (BD) patients and the correlation of the S100A12 serum level with disease activity of BD. Methods We included in this study ten BD patients who fulfilled the criteria for diagnosis, according to the International Study Group for BD. The activity of BD was calculated using the BD Current Activity Form. The serum concentrations of both S100A12 and interleukin-8 were measured by the enzyme-linked immunosorbent assay, before and after treatment. Immunohistochemical studies were also performed to detect S100A12 expression in the skin. Results The serum S100A12 level was significantly increased in the active BD period (p<0.001), in the inactive BD period (p=0.041) and in patients with active Kawasaki disease (p=0.028), compared with the serum level in the healthy controls. The serum S100A12 level decreased significantly from baseline, compared to post-treatment (p=0.017). The activity score of BD was significantly correlated with the serum level of S100A12 (Spearman's coefficient=0.464, p=0.039). Immunohistochemical studies showed that S100A12 was strongly expressed in the erythema nodosum-like skin lesions of patients. Conclusion S100A12 contributes to the pathogenesis of BD related to neutrophil hyperactivity and reflects the disease activity in BD patients.
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Affiliation(s)
- Eun Chun Han
- Department of Dermatology and Cutaneous Biology Research Institute, Seoul, Korea
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De Cassan C, De Vroey B, Dussault C, Hachulla E, Buche S, Colombel JF. Successful treatment with adalimumab in a familial case of gastrointestinal Behcet's disease. J Crohns Colitis 2011; 5:364-8. [PMID: 21683309 DOI: 10.1016/j.crohns.2011.03.006] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2011] [Revised: 03/10/2011] [Accepted: 03/11/2011] [Indexed: 12/21/2022]
Abstract
We present here two siblings with a history of recurrent oral and genital ulcers, neurological and gastrointestinal manifestations. The diagnosis of Behçet's disease in a context of familial aggregation was assumed. Facing repeated steroid-dependent flares and failure of maintenance therapies with colchicine and intolerance to pentoxifilline and disulone, adalimumab was started. Rapid response was observed in both patients, with clinical remission after induction therapy, which currently sustains under maintenance schedule. This case report suggests the effectiveness of adalimumab as first anti-TNFα in case of steroid-dependent/resistant gastrointestinal BD.
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Affiliation(s)
- Chiara De Cassan
- Clinique des Maladies de l'Appareil Digestif et de la Nutrition, Centre Hospitalier Régional Universitaire de Lille, Hôpital Claude Huriez, 59037 Lille, France.
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Macey M, Hagi-Pavli E, Stewart J, Wallace GR, Stanford M, Shirlaw P, Fortune F. Age, gender and disease-related platelet and neutrophil activation ex vivo in whole blood samples from patients with Behçet's disease. Rheumatology (Oxford) 2011; 50:1849-59. [PMID: 21719422 DOI: 10.1093/rheumatology/ker177] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
OBJECTIVES Behçet's disease (BD) is more severe among young males and disease severity decreases with age. Therefore, the effect of disease activity, gender and age on platelet and neutrophil activation in whole blood taken from patients with BD was investigated. METHODS Using an anti-coagulant Tripotassium ethylenediaminetetra acetic acid (K3EDTA) plus citrate-theophylline-adenosine-dipyridamole (CTAD) (K3EDTA/CTAD) that preserves the degree of platelet activation that exists in vivo, we assessed neutrophil and platelet activation, microparticles, and monocyte and neutrophil-platelet aggregate formation in 43 BD patients using flow cytometry. This is the first description of platelet activation and microparticles in BD patients using this methodology. RESULTS Inactive [2.78 (0.56)%, P = 0.0009; 3.11 (0.78)%, P < 0.0001] and active [2.28 (0.84)%, P < 0.0001; 3.071 (0.67)%, P = 0.0031] BD patients had significantly higher percentages of CD62P-expressing platelets and CD62P+ platelet microparticles as compared with healthy controls (HCs) [0.84 (0.1)% and 1.23 (0.14)%], respectively. The percentages of CD62P+ platelets and CD62P+ platelet microparticles in female and male BD patients were also significantly higher than those expressed by female and male HCs. The percentages of CD62P+ microparticles were significantly increased in the 20-30-(P = 0.0301) and 31-50-(P < 0.0162) year age ranges, but not in the >50-year age group of BD patients. CONCLUSION BD is a rare, chronic multi-systemic vasculitis and interaction of activated platelets with leucocytes has been linked to pathological disorders associated with vascular inflammation. Importantly, this study demonstrates that platelet microparticle activation is increased in BD. Also, this is the first report in which changes in platelet activation in BD are concordant with the observations that BD disease activity diminishes with age.
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Affiliation(s)
- Marion Macey
- Department of Haematology, The Royal London Hospital,Whitechapel, UK
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Tang Y, Xu J, Xu Z. Supra-annular aortic replacement in Behcet's disease: a new surgical modification to prevent valve detachment. Int J Cardiol 2011; 149:385-6. [PMID: 21470701 DOI: 10.1016/j.ijcard.2011.03.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2011] [Accepted: 03/03/2011] [Indexed: 11/27/2022]
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Kotsis T, Moulakakis KG, Mylonas S, Andrikopoulos V. Vascular manifestations of Behcet's disease: report of a case and review of the literature. Phlebology 2011; 26:249-53. [PMID: 21478143 DOI: 10.1258/phleb.2010.010024] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Adamantiades-Behçet's disease (ABD) is a relapsing vasculitis of unknown aetiology and variable clinical manifestations. The syndrome can be presented in a myriad of ways and can involve nearly every organ. Although vascular involvement is not included among the ABD diagnostic criteria, it is a unique clinical manifestation in adults with a potentially devastating outcome. We report an ABD case, presenting with a thrombotic occlusion of the inferior vena cava. The authors review the recent literature, emphasizing the spectrum of vascular manifestations accompanying Behçet's disease.
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Affiliation(s)
- T Kotsis
- Department of Vascular Surgery, 'Red Cross' General Hospital, Andrea Papandreou 132 Street, Glyfada, Athens 16561, Greece
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Ramachandran R, Hughes E, Larkin G, Graham E, Stanford M, Lim M. Secondary frosted branch angiitis in neuro-Behçet's disease with serous macular detachment. Pediatr Int 2011; 53:285-6. [PMID: 21501319 DOI: 10.1111/j.1442-200x.2011.03343.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Diagnostic value of pathergy test in Behcet’s disease according to the change of incidence over the time. Clin Rheumatol 2011; 30:1151-5. [DOI: 10.1007/s10067-011-1694-5] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2010] [Revised: 12/24/2010] [Accepted: 01/13/2011] [Indexed: 11/29/2022]
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Verma A, Kumar P, Babb K, Timoney JF, Stevenson B. Cross-reactivity of antibodies against leptospiral recurrent uveitis-associated proteins A and B (LruA and LruB) with eye proteins. PLoS Negl Trop Dis 2010; 4:e778. [PMID: 20689825 PMCID: PMC2914785 DOI: 10.1371/journal.pntd.0000778] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2009] [Accepted: 06/30/2010] [Indexed: 11/19/2022] Open
Abstract
Infection by Leptospira interrogans has been causally associated with human and equine uveitis. Studies in our laboratories have demonstrated that leptospiral lipoprotein LruA and LruB are expressed in the eyes of uveitic horses, and that antibodies directed against LruA and LruB react with equine lenticular and retinal extracts, respectively. These reactivities were investigated further by performing immunofluorescent assays on lenticular and retinal tissue sections. Incubation of lens tissue sections with LruA-antiserum and retinal sections with LruB-antiserum resulted in positive fluorescence. By employing two-dimensional gel analyses followed by immunoblotting and mass spectrometry, lens proteins cross-reacting with LruA antiserum were identified to be alpha-crystallin B and vimentin. Similarly, mass spectrometric analyses identified beta-crystallin B2 as the retinal protein cross-reacting with LruB-antiserum. Purified recombinant human alpha-crystallin B and vimentin were recognized by LruA-directed antiserum, but not by control pre-immune serum. Recombinant beta-crystallin B2 was likewise recognized by LruB-directed antiserum, but not by pre-immune serum. Moreover, uveitic eye fluids contained significantly higher levels of antiibodies that recognized alpha-crystallin B, beta-crystallin B2 and vimentin than did normal eye fluids. Our results indicate that LruA and LruB share immuno-relevant epitopes with eye proteins, suggesting that cross-reactive antibody interactions with eye antigens may contribute to immunopathogenesis of Leptospira-associated recurrent uveitis.
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Affiliation(s)
- Ashutosh Verma
- Department of Microbiology, Immunology and Molecular Genetics, University of Kentucky College of Medicine, Lexington, Kentucky, USA.
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Chiu HH, Wang SS, Wu MH, Wang JK. Aortitis with severe aortic regurgitation in Behcet's disease: a case report. J Formos Med Assoc 2010; 109:82-4. [PMID: 20123590 DOI: 10.1016/s0929-6646(10)60025-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
Behcets aortitis is a rare, but one of the most severe complications of Behcets disease. We report a 24-year old woman who was noted initially to have aortitis and severe aortic regurgitation caused by Behcets disease. After receiving aortic valve replacement, aortoplasty and immunosuppressant therapy, her condition became stationary. As far as we are aware, she is the youngest case that has undergone surgery. The early onset of hemodynamic decompensation is considered to be related to delay in diagnosis and lack of steroid treatment.
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Affiliation(s)
- Hsin-Hui Chiu
- Department of Pediatrics, National Taiwan University Hospital and Medical College, National Taiwan University, Taipei, Taiwan
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Arabaci T, Kara C, Çiçek Y. Relationship between periodontal parameters and Behçet’s disease and evaluation of different treatments for oral recurrent aphthous stomatitis. J Periodontal Res 2009; 44:718-25. [DOI: 10.1111/j.1600-0765.2008.01183.x] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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Bowman C, Delrieu O. Immunogenetics of drug-induced skin blistering disorders. Part I: Perspective. Pharmacogenomics 2009; 10:601-21. [PMID: 19374517 DOI: 10.2217/pgs.09.11] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
The overall immunopathogenesis relevant to a large series of disorders caused by a drug or its associated hyperimmune condition is discussed based upon the examination of the genetics of severe drug-induced bullous skin problems (sporadic idiosyncratic adverse events, including Stevens-Johnson syndrome and toxic epidermal necrolysis). An overarching pharmacogenetic schema is proposed. Immune cognition and early-effector processes are focused upon and a challenging synthesis around systems evolution is explained by a variety of projective analogies. Etiology, human leukocyte antigen-B, immune stability, dysregulation, pharmacomimicry, viruses and an aggressive ethnically differentiated 'karmic' response are discussed.
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Affiliation(s)
- Clive Bowman
- School of Biological Sciences, The University of Reading, Whiteknights, Reading, RG6 6AH, UK.
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Keogan MT. Clinical Immunology Review Series: an approach to the patient with recurrent orogenital ulceration, including Behçet's syndrome. Clin Exp Immunol 2009; 156:1-11. [PMID: 19210521 PMCID: PMC2673735 DOI: 10.1111/j.1365-2249.2008.03857.x] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/25/2008] [Indexed: 01/30/2023] Open
Abstract
Patients presenting with recurrent orogenital ulcers may have complex aphthosis, Behçet's disease, secondary complex aphthosis (e.g. Reiter's syndrome, Crohn's disease, cyclical neutropenia) or non-aphthous disease (including bullous disorders, erythema multiforme, erosive lichen planus). Behçet's syndrome is a multi-system vasculitis of unknown aetiology for which there is no diagnostic test. Diagnosis is based on agreed clinical criteria that require recurrent oral ulcers and two of the following: recurrent genital ulcers, ocular inflammation, defined skin lesions and pathergy. The condition can present with a variety of symptoms, hence a high index of suspicion is necessary. The most common presentation is with recurrent mouth ulcers, often with genital ulcers; however, it may take some years before diagnostic criteria are met. All patients with idiopathic orogenital ulcers should be kept under review, with periodic focused assessment to detect evolution into Behçet's disease. There is often a delay of several years between patients fulfilling diagnostic criteria and a diagnosis being made, which may contribute to the morbidity of this condition. Despite considerable research effort, the aetiology and pathogenesis of this condition remains enigmatic.
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Affiliation(s)
- M T Keogan
- Department of Immunology, Beaumont Hospital, Dublin, Ireland.
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Karacayli U, Mumcu G, Simsek I, Pay S, Kose O, Erdem H, Direskeneli H, Gunaydin Y, Dinc A. The close association between dental and periodontal treatments and oral ulcer course in behcet’s disease: a prospective clinical study. J Oral Pathol Med 2009; 38:410-5. [DOI: 10.1111/j.1600-0714.2009.00765.x] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Sosroseno W. Effect of colchicine on the murine immune response induced by Aggregatibacter actinomycetemcomitans. Biomed Pharmacother 2009; 63:221-7. [DOI: 10.1016/j.biopha.2008.04.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2008] [Accepted: 04/02/2008] [Indexed: 11/15/2022] Open
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Ebert EC. Gastrointestinal manifestations of Behçet's disease. Dig Dis Sci 2009; 54:201-7. [PMID: 18594975 DOI: 10.1007/s10620-008-0337-4] [Citation(s) in RCA: 66] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2008] [Accepted: 05/06/2008] [Indexed: 12/13/2022]
Abstract
Behçet's disease is a rare vasculitis diagnosed by the presence of recurrent oral ulcers and two of the following: genital ulcers, typical eye lesions, typical skin lesions, and positive pathergy test. It is most commonly seen in countries along the ancient silk road from Eastern Asia to the Mediterranean Basin. Young adults between the second and fourth decades of life are mainly affected, with abdominal pain being the most common symptom. The ileocecal region is most commonly affected, with ulcerations that may penetrate or perforate. Rarely, the esophagus and stomach may have ulcerations. Bowel wall thickening is the most common finding on computed tomography (CT) scan. Pathology shows a vasculitis mainly involving the small veins or, alternatively, nonspecific inflammation. Corticosteroids, with or without other immunosuppressive drugs, are used for severe eye disease. Their use in intestinal disease is largely empirical. Surgery may be required for perforation. Behçet's disease runs a chronic, unpredictable course with exacerbations and remissions which decrease in frequency and severity over time. Death is mainly due to major vessel disease and neurological involvement.
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Affiliation(s)
- Ellen C Ebert
- UMDNJ-Robert Wood Johnson Medical School, New Brunswick, NJ 08903, USA.
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Yalçindag FN, Yalçindag A, Batioglu F, Çaglayan O, Kisa Ü, Özdemir Ö. Evaluation of serum resistin levels in patients with ocular and non-ocular Behçet’s disease. CANADIAN JOURNAL OF OPHTHALMOLOGY 2008; 43:473-475. [DOI: 10.3129/i08-081] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/30/2023]
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Yalçındağ FN, Kısa Ü, Batıoğlu F, Yalçındağ A, Özdemir Ö, Çağlayan O. Serum leptin levels in patients with ocular and nonocular Behçet's disease. Mediators Inflamm 2008; 2007:31986. [PMID: 17641728 PMCID: PMC1906708 DOI: 10.1155/2007/31986] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2007] [Accepted: 03/13/2007] [Indexed: 11/18/2022] Open
Abstract
Aims. To investigate serum leptin levels in Behçet's patients with or without ocular involvement compared with healthy subjects and the relationship between serum leptin and uveitis activity in patients with ocular involvement. Methods. Fifty-seven patients with Behçet's disease and 20 healthy control subjects were
included in this study. While 27 patients had ocular involvement (18 had acute uveitis, 9 had inactive ocular involvement), 30 did not have ocular disease. C-reactive protein, alpha 1-antitrypsin, and serum leptin levels were measured in all samples.
Results. There was a significant difference between the patients with Behçet's disease and control group for both logarithm of leptin (P = .000) and logarithm of CRP (P = .031). Logarithm of leptin in non-ocular Behçet's patients was significantly higher compared to its level in ocular Behçet's disease and controls (P = .009). There was a significant difference between the patients with active ocular disease and control group (P = .03). Conclusions. Leptin might have a possible role in the pathogenesis of Behçet's disease.
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Affiliation(s)
- F. Nilüfer Yalçındağ
- Department of Ophthalmology, Faculty of Medicine, Ankara University, 06100 Ankara, Turkey
- *F. Nilüfer Yalçındağ:
| | - Üçler Kısa
- Department of Clinical Biochemistry, Faculty of Medicine, Kırıkkale University, 71200 Kırıkkale, Turkey
| | - Figen Batıoğlu
- Department of Ophthalmology, Faculty of Medicine, Ankara University, 06100 Ankara, Turkey
| | - Ali Yalçındağ
- Department of Clinical Biochemistry, Faculty of Medicine, Kırıkkale University, 71200 Kırıkkale, Turkey
| | - Özden Özdemir
- Department of Ophthalmology, Faculty of Medicine, Ankara University, 06100 Ankara, Turkey
| | - Osman Çağlayan
- Department of Clinical Biochemistry, Faculty of Medicine, Kırıkkale University, 71200 Kırıkkale, Turkey
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Sadreddini S, Noshad H, Molaeefard M, Noshad R. Treatment of retinal vasculitis in Behçet's disease with rituximab. Mod Rheumatol 2008. [PMID: 18438602 DOI: 10.3109/s10165-008-0057-9] [Citation(s) in RCA: 56] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Behçet's disease (BD) is more common in eastern than western countries. Physicians have frequently encountered problems in its treatment, especially eye involvement. Recurrent oral and genital aphthous ulcerations are the hallmarks of Behçet's disease but other organs can be involved and ocular disease is one of the most disabling manifestations. Up to now, there are some problems in treatment of the retinal vasculitis due to Behçet's disease. We reported one patient, with visual loss due to retinal vasculitis that was resistant to prednisolone and azathioprine. Our patient was treated successfully with rituximab and his remission was sustained for 24 months of follow-up. Rituximab is a chimeric monoclonal antibody that acts against the specific B cell antigen, CD20. The recent success of rituximab in autoimmune diseases, which is considered to be T cell-mediated, indicates that B cells must have a much broader role in the pathogenesis of autoimmune diseases than generally appreciated.
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Sadreddini S, Noshad H, Molaeefard M, Noshad R. Treatment of retinal vasculitis in Behçet's disease with rituximab. Mod Rheumatol 2008; 18:306-8. [PMID: 18438602 DOI: 10.1007/s10165-008-0057-9] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2007] [Accepted: 01/24/2008] [Indexed: 10/22/2022]
Abstract
Behçet's disease (BD) is more common in eastern than western countries. Physicians have frequently encountered problems in its treatment, especially eye involvement. Recurrent oral and genital aphthous ulcerations are the hallmarks of Behçet's disease but other organs can be involved and ocular disease is one of the most disabling manifestations. Up to now, there are some problems in treatment of the retinal vasculitis due to Behçet's disease. We reported one patient, with visual loss due to retinal vasculitis that was resistant to prednisolone and azathioprine. Our patient was treated successfully with rituximab and his remission was sustained for 24 months of follow-up. Rituximab is a chimeric monoclonal antibody that acts against the specific B cell antigen, CD20. The recent success of rituximab in autoimmune diseases, which is considered to be T cell-mediated, indicates that B cells must have a much broader role in the pathogenesis of autoimmune diseases than generally appreciated.
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LruA and LruB antibodies in sera of humans with leptospiral uveitis. CLINICAL AND VACCINE IMMUNOLOGY : CVI 2008; 15:1019-23. [PMID: 18400972 DOI: 10.1128/cvi.00203-07] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Uveitis can be a serious complication of leptospirosis. Previous studies indicated that the leptospiral lipoproteins LruA and LruB are expressed in the eyes of uveitic horses and that antibodies directed against those proteins show in vitro cross-reactivity with components of equine lens, ciliary body, and/or retina. We now demonstrate that sera from a significant proportion of humans who have leptospiral uveitis also contain antibodies against LruA and LruB. Different categories of nonleptospiral uveitis and autoimmune uveitis were also screened; patients diagnosed with Fuchs uveitis or Behçet's syndrome produced antibodies that cross-reacted with LruA and LruB, suggesting similarities of the autoimmune responses in those diseases with those of leptospiral uveitis.
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Akman A, Sallakci N, Kacaroglu H, Tosun O, Yavuzer U, Alpsoy E, Yegin O. Relationship between periodontal findings and the TNF-alpha Gene 1031T/C polymorphism in Turkish patients with Behçet's disease. J Eur Acad Dermatol Venereol 2008; 22:950-7. [PMID: 18355201 DOI: 10.1111/j.1468-3083.2008.02678.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Genetic factors that predispose individuals to Behçet's disease (BD) and periodontal disease. Tumour necrosis factor-alpha (TNF-alpha) has been implicated in the pathogenesis of both BD and periodontal disease. The relationship with periodontitis and the pathogenesis of BD has not yet been determined. OBJECTIVE The aim of the present study was to investigate the possible relation of the periodontal scores and single nucleotide polymorphism of TNF-alpha-1031T/C with BD compared with healthy controls (HC) and recurrent aphtous stomatitis (RAS). We also sought to determine the effects of periodontal condition and TNF-alpha-1031T/C polymorphism on clinical severity of BD. METHODS Eighty-two unrelated patients with BD, 42 RAS patients and 77 HC were enrolled in the study. Periodontal status of all subjects was evaluated according to the World Health Organization community periodontal index of treatment needs (CPITN). For genotyping, polymerase chain reaction-restriction fragment length polymorphism was employed. RESULTS The mean CPITN was observed to be higher in patients with BD compared with HC and RAS (P < 0.001). TNF-alpha-1031C allele was significantly higher in patients with BD (P = 0.023) and RAS (P = 0.007) compared with HC. Mean CPITN was higher in CC genotype compared with other genotypes (P = 0.004). Moreover, CPITN and CC genotype was found to be correlated with the severity of the disease. CONCLUSIONS Our data indicate that the TNF-alpha-1031T/C gene polymorphism (CC genotype) is a risk factor for periodontitis, RAS and BD patients and also suggests that long-term periodontal follow-up and education of oral hygiene in patients with BD may help to prevent the development and/or progression of the disease.
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Affiliation(s)
- A Akman
- Department of Dermatology and Venerology, Akdeniz University School of Medicine, Antalya, Turkey
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42
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Arduino PG, Porter SR. Herpes Simplex Virus Type 1 infection: overview on relevant clinico-pathological features. J Oral Pathol Med 2008; 37:107-21. [PMID: 18197856 DOI: 10.1111/j.1600-0714.2007.00586.x] [Citation(s) in RCA: 199] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Herpes Simplex Virus Type 1 (HSV-1) is a nuclear replicating enveloped virus, usually acquired through direct contact with infected lesions or body fluids (typically saliva). The prevalence of HSV-1 infection increases progressively from childhood, the seroprevalence being inversely related to socioeconomic background. Primary HSV-1 infections in children are either asymptomatic or following an incubation period of about 1 week gives rise to mucocutaneous vesicular eruptions. Herpetic gingivostomatitis typically affects the tongue, lips, gingival, buccal mucosa and the hard and soft palate. Most primary oro-facial HSV infection is caused by HSV-1, infection by HSV-2 is increasingly common. Recurrent infections, which occur at variable intervals, typically give rise to vesiculo-ulcerative lesions at mucocutaneous junctions particularly the lips (herpes labialis). Recurrent HSV-1 infection within the mouth is uncommon in otherwise healthy patients, although in immunocompromised patients, recurrent infection can be more extensive and/or aggressive. The diagnosis of common herpetic infection can usually be based upon the clinical history and presenting features. Confirmatory laboratory diagnosis is, however, required when patients are, or may be, immunocompromised.
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Affiliation(s)
- Paolo G Arduino
- Department of Biomedical Sciences and Human Oncology, Oral Medicine Section, University of Turin, Turin, Italy.
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Lew W, Chang J, Jung J, Bang D. Increased expression of interleukin-23 p19 mRNA in erythema nodosum-like lesions of Behçet’s disease. Br J Dermatol 2008; 158:505-11. [DOI: 10.1111/j.1365-2133.2007.08403.x] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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Heo JH, Lee ST, Chu K, Kim M. Neuro-Behcet's disease mimicking multiple brain tumors: Diffusion-weighted MR study and literature review. J Neurol Sci 2008; 264:177-81. [PMID: 17850821 DOI: 10.1016/j.jns.2007.07.029] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2007] [Revised: 07/16/2007] [Accepted: 07/25/2007] [Indexed: 11/29/2022]
Abstract
A 47-year-old man with Behcet's disease presented with a five day history of right side weakness and dysarthria. Ten years ago, he was diagnosed as Behcet's disease. Since then, he was treated with low dose steroids. T1-weighted magnetic resonance images with gadolinium injection revealed ring enhancing lesions with internal hypointensities at the left side of the pons and at the left parietal cortex suggesting multiple metastatic tumors. Diffusion-weighted image and ADC map revealed central hyperintensity on diffusion with low ADC values at both lesions. The histopathology of stereotactic biopsy specimen showed frequent perivascular lymphocytic cuffings, focal necrotic lesions and reactive gliosis. The most common neuropathologic findings in neuro-Behcet's disease are focal necrotic lesions, but the location in cerebral cortex has not been reported before. Long term steroid therapy and antibiotics were administered and the patient recovered gradually. Neuro-Behcet's disease could be presented as brain tumor like lesion, and stereotactic biopsy should be considered in such situation.
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Affiliation(s)
- Jae-Hyeok Heo
- Department of Neurology, Seoul National University Hospital, 28 Yeongeon-dong, Jongno-gu, Seoul, 110-744, South Korea
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Kose O, Stewart J, Waseem A, Lalli A, Fortune F. Expression of cytokeratins, adhesion and activation molecules in oral ulcers of Behçet's disease. Clin Exp Dermatol 2007; 33:62-9. [PMID: 17983454 DOI: 10.1111/j.1365-2230.2007.02558.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
BACKGROUND Behçet's disease (BD) is a multisystemic inflammatory disorder of which oral aphthous ulceration is a major feature. AIMS/HYPOTHESIS. This study sought to determine the role of cytokeratins, differentiation and proliferation markers, gammadelta T-cell adhesion and activation molecules, and apoptotic markers in oral ulcers of this disease. METHODS Expression patterns for cytokeratins (K1, K6, K14, K15, K16), integrins (beta1 and alpha6), CD3 T-cell and gammadelta T-cell adhesion and activation markers [CD40, CD44, CD54, ICAM-1, CD58, leucocyte function-associated antigen (LFA)-3, vascular cell adhesion molecule-1 (VCAM-1), CD86], and cellular proliferation and differentiation markers (Ki67 and involucrin), and apoptotic markers (CD95 and Bcl-2) in oral ulcers of nine patients with BD and four healthy controls were analysed by immunohistochemistry. RESULTS K14, K15 and involucrin expression were unchanged, whereas Ki67, the proliferation marker, was reduced by around 50%. K1, K6, K16, beta1 integrin and the apoptotic marker CD95 were upregulated, whereas alpha6 integrin and Bcl-2 were downregulated in BD samples. CD3 and gammadelta T-cell expression and other adhesion molecules including CD44, CD86, CD58 (LFA-3), VCAM-1 and intercellular adhesion molecule-1 (CD54) were upregulated, whereas CD40 showed little change. CONCLUSIONS Our data demonstrates changes in cell-cell and cell-extracellular matrix interactions that affect cell homeostasis and may participate in the formation of oral ulcers in BD.
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Affiliation(s)
- O Kose
- Gulhane School of Medicine (GATA), Department of Dermatology, Ankara, Turkey
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Akman A, Kacaroglu H, Donmez L, Bacanli A, Alpsoy E. Relationship between periodontal findings and Behçet's disease: a controlled study. J Clin Periodontol 2007; 34:485-91. [PMID: 17451414 DOI: 10.1111/j.1600-051x.2007.01085.x] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND Behçet's disease (BD) is a chronic, relapsing, systemic vasculitis of unknown aetiology. The involvement of oral mucosal surfaces represents the onset feature of the disease in the majority of patients. OBJECTIVE The aim of this study was to evaluate the periodontal status of BD patients and then compare with recurrent aphthous stomatitis (RAS) patients and healthy controls. We also determined the relationship between the periodontal condition and the clinical severity of the disease in BD patients. METHODS Eighty-six patients with BD, 63 patients with RAS and 82 healthy subjects were included in the study. The periodontal status of all subjects was evaluated according to the community periodontal index of treatment needs (CPITN). BD patients were also assessed for clinical severity score (CSS) as described previously. RESULTS The mean CPITN were observed to be higher in BD patients (1.79 +/- 0.96) compared with RAS patients (1.22 +/- 0.87) and healthy controls (1.18 +/- 0.98) (p<0.001). There was a positive association between CSS and CPITN (p=0.017) in BD patients. CONCLUSION Our results showed that periodondal status is worse in BD patients and associated with disease severity. We can speculate that periodontitis may induce a systemic inflammatory process that may contribute to the development and/or progression of BD.
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Affiliation(s)
- Ayse Akman
- Department of Dermatology and Venerology, Akdeniz University School of Medicine, Antalya, Turkey.
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Oztas S, Gullulu G, Tatar A, Astam N, Akyol I, Karakuzu A, Aktas A, Odabas AR. Chromosome and sister chromatid exchange studies in Behcet's patients. J Dermatol 2006; 33:406-10. [PMID: 16700831 DOI: 10.1111/j.1346-8138.2006.00096.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Behcet's disease is a chronic multisystemic disease of unknown pathogenesis characterized by four major symptoms: oral aphthous ulcers, skin lesions, ocular symptoms and genital ulcerations. The disease is spread throughout the world, but it is most frequent in Turkey, Japan, Korea and China. Although HLA-Bw51 has been found to predominate in Behcet's cases, the genetic etiology has not yet been clarified. In this study, we investigated the chromosomal abnormalities and sister chromatid exchange rates in patients with Behcet's diseases. Thirty-eight patients with Behcet's disease (diagnosed for the first time) and 30 healthy subjects (as controls) were included in this study. Although numerical and structural chromosomal abnormalities were not detected in our patients, we found an increased rate of sister chromatid exchange in patients over the control groups (P < 0.01). On the basis of these results, we discuss the genetic etiology of Behcet's disease.
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Affiliation(s)
- Sitki Oztas
- Department of Medical Genetics, Ataturk University Medical Faculty, Erzurum, Turkey.
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Mumcu G, Inanc N, Ergun T, Ikiz K, Gunes M, Islek U, Yavuz S, Sur H, Atalay T, Direskeneli H. Oral health related quality of life is affected by disease activity in Behçet's disease. Oral Dis 2006; 12:145-51. [PMID: 16476035 DOI: 10.1111/j.1601-0825.2005.01173.x] [Citation(s) in RCA: 96] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
OBJECTIVES This study aimed to investigate oral and general health related quality of life (QoL) in patients with Behçet's Disease (BD) and to assess the performance of Turkish versions of oral health related quality questionnaires. SUBJECTS AND METHODS Ninety-four BD patients, 24 patients with recurrent aphthous stomatitis (RAS), 113 healthy controls (HC) and 44 dental patients were investigated. QoL was assessed by oral health impact profile-14 (OHIP-14), oral health related quality of life (OHQoL) and short form-36 (SF-36) questionnaires. RESULTS OHQoL, OHIP-14 and SF-36 subscale scores were significantly worse in patients with BD compared with those in HC (P < 0.05). Both OHIP-14 and OHQoL scores were significantly worse in active patients compared with inactives in BD and RAS (P < 0.05). Scores of SF-36 Role physical, Role emotional and Vitality were also lower in active patients than in inactives in BD (P < 0.05). Scores of OHIP-14 and OHQoL were significantly worse in patients treated with colchicine compared with those treated with immunosuppressives (P < 0.05). CONCLUSIONS Both oral and general QoL was impaired in BD and associated with disease activity and treatment modalities. Translated Turkish versions of OHIP-14 and OHQoL were also observed to be valid and reliable questionnaires for further studies.
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Affiliation(s)
- G Mumcu
- Department of Basic Health Science, Faculty of Health Education, Marmara University, Istanbul, Turkey.
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Abstract
Recurrent aphthous stomatitis (RAS; aphthae; canker sores) is a common condition which is characterized by multiple recurrent small, round or ovoid ulcers with circumscribed margins, erythematous haloes, and yellow or grey floors typically presenting first in childhood or adolescence. RAS occurs worldwide although it appears most common in the developed world. The aetiology of RAS is not entirely clear. Despite many studies trying to identify a causal microorganism, RAS does not appear to be infectious. A genetic predisposition is present, as shown by strong associations with genotypes of IL-1beta; IL-6 in RAS patients, and a positive family history in about one-third of patients with RAS. Haematinic deficiency is found in up to 20% of patients. Cessation of smoking may precipitate or exacerbate RAS in some cases. Ulcers similar to RAS may be seen in human immunodeficiency virus disease and some other immune defects, and drugs, especially non-steroidal anti-inflammatory drugs and nicorandil may produce lesions clinically similar to RAS. Topical corticosteroids can often control RAS. However, the treatment of RAS remains unsatisfactory, as most therapies only reduce the severity of the ulceration and do not stop recurrence.
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Affiliation(s)
- S Jurge
- Oral Medicine, Eastman Dental Institute, University College London, UK
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Silva Júnior OFD, Araújo RHDS, Freire EAM, Travassos Júnior RR, Cavalcante TER, Lucena TJP, Nogueira Neto NDC, Melo AVDA. Doença de Behçet cursando com trombose de veia cava superior. J Vasc Bras 2006. [DOI: 10.1590/s1677-54492006000100015] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
A trombose venosa é o principal acometimento do sistema vascular na doença de Behçet, sendo uma complicação freqüente na evolução clínica dessa patologia, e está mais associada ao sexo masculino. Os autores relatam o caso de uma paciente do sexo feminino que apresentou início da doença há 3 anos com úlceras orais, além de úlceras genitais, e que vem cursando com episódios recorrentes de trombose venosa, sendo a primeira uma trombose venosa profunda no membro inferior direito; a segunda, de jugular interna esquerda; e, por último, uma trombose da veia cava superior.
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