Clinical manifestations of Behçet's disease in a large cohort of Chinese patients: gender- and age-related differences

Clin Rheumatol. 2020 Nov;39(11):3449-3454. doi: 10.1007/s10067-020-05026-2. Epub 2020 May 11.

Abstract

Objectives: To investigate the clinical characteristics of Bechet's disease (BD) with respect to gender and age in China.

Method: Clinical data of 489 BD patients admitted to Peking Union Medical College Hospital (PUMCH) and registered by the BD registry database established by PUMCH from March 2014 to January 2019 were collected and analyzed in this study. Demographics, medical histories, clinical manifestations, laboratory test results, imaging findings, assessment of disease activity, treatment regimen, as well as the outcomes were reviewed.

Results: A total of 489 BD patients were included in this study, among them 286 males (58.5%) and 203 females (41.5%) with a male-to-female ratio of 1.41 and a median age of 34 years (interquartile range 28-44 years old). The results revealed that ocular lesions (P = 0.005), vascular lesions(P < 0.001), pseudofolliculitis (P < 0.001), and positive pathergy test (P = 0.002) were more commonly found in males, while genital ulceration was more prevalent in females (P < 0.001). Vascular lesions (P = 0.024) and gastrointestinal ulcers (P = 0.010) were more common in BD patients after the age of 40, while pseudofolliculitis was more common in patients under the age of 40 (P = 0.004) and ocular lesions (P = 0.017) occurred mainly in patients under the age of 35. Male predominance of ocular involvement was more apparent in their third decades (Padjusted< 0.006), while vascular lesions were prominently presented in male patients at the age of 30-40 (Padjusted= 0.006). Female predominance of genital ulcers was observed in patients at the age of 30-40 (Padjusted< 0.006).

Conclusions: The clinical characteristics of BD were different with respect to gender and age. Key Points • Ocular and vascular lesions, pseudofolliculitis, and positive pathergy test were more common in male BD patients. • Genital ulceration showed female predominance in BD patients. • Vascular lesions and gastrointestinal ulcers were more common in older BD patients. • Pseudofolliculitis and ocular lesions occurred mainly in younger BD patients.

Keywords: Age; Bechet’s disease; Gender; Phenotypical differences.

MeSH terms

  • Adult
  • Aged
  • Behcet Syndrome* / complications
  • Behcet Syndrome* / diagnosis
  • Behcet Syndrome* / epidemiology
  • China / epidemiology
  • Cohort Studies
  • Databases, Factual
  • Female
  • Gastrointestinal Diseases*
  • Humans
  • Male