Disease characteristics of Behcet’s Disease among Filipino patients seen in Rheumatology Clinics

ABSTRACT

Introduction@#Behcet's disease (BD) sometimes called behcet's syndrome or silk road disease is an immunemediated systemic vasculitis. This condition remains a clinical challenge for physicians. There are many reports, mostly case series and nationwide surveys, on clinical manifestations of BD from different parts of the world. In the Philippines where BD is rare and underreported, physicians might not be familiar with the clinical manifestations of this disease. The aim of this research is to describe the disease presentation of BD among Filipinos to increase awareness and avoid delay in diagnosis which might pose a threat for the development of irreversible, sometimes fatal complications.@*Methods@#A manual search was done for medical records with diagnosis of BD in the clinics of rheumatology staff of PGH. The diagnosis of BD was based on the 2006 International Criteria for BD. We noted the demographic data, clinical manifestations, results of ancillary procedures, treatment and outcomes. The study follows a descriptive design. @*Results@#There were 31 patients with the diagnosis of BD found from the manual search. Most of them were female (77%). The mean age at diagnosis was 38.6 years ± 10.4 (SD) and the mean time duration from onset of first symptom to diagnosis was 41 months (range three to 180 months). Three patients had a family member who also had BD (10%). The most common features of the disease were oral ulcers (94%), ocular manifestation (68%), and cutaneous disease (65%). The pathergy test was positive in 17%.The most common treatments prescribed were oral steroids (74%), colchicine (58%), and NSAIDs (48%). There was symptom control or improvement in a third of patients but there were still symptom recurrence in some. Thirteen patients (42%) had recurrent oral ulcerations while 23% had recurrence of skin lesions. Two of the patients (six percent) developed blindness. There was no death recorded. @*Conclusion@#There is an average delay of three years in the diagnosis of BD that hinders appropriate early treatment. Moreover, BD remains to be a clinical challenge for physicians. While a third of the cohort had good outcomes, half still had symptom recurrences and the occurrence of blindness in two patients underlines the potential of the disease to disable. We recommend expansion of the cohort to include the BD patients of other rheumatologists in the Philippines to have an idea on the actual prevalence and incidence of how this uncommon disease in our locality, and to have a better understanding of its clinical presentation and disease management in our country.