ABSTRACT
OBJECTIVES: The pathergy skin test is a hypersensitivity reaction to a prick skin trauma caused by a pin or a needle, which is considered as a specific presentation in Behçet's disease (BD) and the precise mechanism of this test is not well elucidated. This study was designed to evaluate the association of pathergy reaction (PR) with the active clinical manifestations of BD patients, to assess the clinical importance of PR. MATERIALS AND METHODS: This was a cohort study on 1675 BD patients who fulfilled the entry criteria based on the International Criteria for Behçet's Disease (ICBD) from 1975 to 2011. The patients were divided into two groups; the pathergy positive group included 841 patients (50.2%) and the pathergy negative group 834 patients (49.8%). The active mucocutaneous and systemic disease manifestations were analyzed according to the presence of the PR. The odds ratio and 95% confidence interval (95% CI) were calculated for each item. RESULTS: In this study, 841 patients (50.2%) had a positive pathergy test. Patient's mean age and mean disease duration were similar in the two groups (pathergy positive and pathergy negative patients). There was no association between positive pathergy test and age of patients, or disease duration. The PR was associated with male gender (p = 0.013), oral aphthosis (p < 0.001), pseudofolliculitis (p < 0.001), anterior uveitis (p = 0.001) and posterior uveitis (p = 0.028). CONCLUSIONS: The presence of PR was associated with male gender, as well as some of mucocutaneous manifestations and uveitis in adult patients. There was no association with retinitis and vascular involvements. PR isn't associated with the severity of the disease.
ABSTRACT
AIM: This study was designed to evaluate iron deficiency as a predisposing factor for resistant oral aphthosis in patients with Behcet's disease (BD). METHODS: In a case control study 220 consecutive BD patients with oral aphthosis were enrolled. All patients had been treated for at least 3 months. They were divided into two groups according to their treatment response (75 patients in the Case and 145 in the Control group). Demographic and clinical characteristics of the disease, serum iron, total iron binding capacity and serum ferritin were determined in each patient. We used independent t-test and Mann-Whitney U-test to compare the quantitative variables and chi-square test for qualitative variables. Odds ratio (OR) and confidence interval at 95% (95% CI) were calculated for each item. RESULTS: There was no significant difference between the two groups in demographics or clinical characteristics of the disease. We found iron deficiency in 72 patients (32.7%, 95% CI: 6.2), higher in the Case group than Control (39.2% vs. 30.1%; P = 0.17). Despite the higher frequency of iron deficiency in men (26.8% vs. 14.5%), the difference was not statistically significant (P = 0.09). Multivariate logistic regression analysis showed that none of the iron deficiency or sex variables could predict the development of resistant oral aphthosis. The OR for iron deficiency was 1.52 (95% CI: 0.81-2.86) and for male sex was 1.04 (95% CI: 0.56-1.91). CONCLUSION: Despite the higher frequency of iron deficiency in BD patients with resistant oral aphthosis, we were not able to attribute this resistance to this deficiency.
