Epidemiology of Behcet's disease in Thai patients

Objective: To describe symptoms, signs, laboratory findings and to compare sensitivity of several classification criteria in Thai patients who were diagnosed with Behcet's disease. Material and Method: Using medical records from the rheumatology unit, Siriraj hospital, all cases diagnosed with Behcet's disease by our rheumatology staff were identified and reviewed. Demographic data, clinical presentations, and laboratory data were collected. All cases were also reviewed if they had fulfilled any of the following criteria: Iran classification tree, Japanese, Korean, ISG and O'Duffy's criteria. The sensitivity of each criterion was calculated. Results: Twenty three cases were identified during a 24 year interval (1980-2003). Our population had a mean age of 30.83 years. Common clinical presentations were recurrent oral ulcers 100% (23/23), genital ulcers 69.6% (16/23), eye involvement 52.2% (12/23), skin involvement 60.9% (14/23), GI ulcers 8.7% (2/23), epididymitis 4.3% (1/23), vascular lesions 8.7% (2/23), CNS involvement 8.7% (2/23), fever 60.9% (14/23), and positivity of the pathergy test 33.3% (3/9). The sensitivity of criteria used for diagnosis of our patients with Behcet's disease varied widely. We found that the Iran classification tree criteria had the highest sensitivity followed by those from Japan (82.6%), O'Duffy's(73.9%), ISG (52.2%), and Korean (39.1%) criteria respectively. Conclusion: Behcet's disease is heterogeneous in its manifestations and clinical constellation of the disease varies widely among different parts of the world. This is the first epidemiologic study describing Thai Behcet's patients. We also found the Iran classification tree criteria had the highest sensitivity for diagnosis of Thai patients.