| Objective: To analyze and summarize the clinical characteristics of Behcet's disease(BD)and the gender as well as age group differences so as to improve the cognition of this disease.Methods: A total of 135 BD patients diagnosed for the first time at the First Affiliated Hospital of China Medical University from May 2010 to August 2017 were enrolled.Meanwhile,the cases presented were conformed to the international criteria for Behcet's disease which was set by the International Study Group for Behcet's disease in 2013.The clinical data was analyzed statistically with SPSS 24.0 software.Results:(1)Generally,50 cases were males,85 cases were females and the ratio of male to female was 0.59:1 among 135 patients.The patients were 14-72 years old with average age of 36.96±13.91 years.It existed 51 cases under 30 years old(including 5 cases under18 years old),57 cases in 30 to 50 years old,and 27 cases over 50 years old.The duration of the patients was from 4 days to 30 years and the average disease course was 3(7.67)years.5 cases took up inducements or causes before the onset of disease,such as Oral cephalosporin drugs,lavaging after bladder cancer,carrying on PPD test and upper respiratory tract infections.(2)Clinical manifestations at disease were oral ulcers 132cases(97.78%),genital ulcers 111 cases(82.22%),ocular involvement 33 cases(24.44%,occurring in 4.04±3.80 years after the initial symptoms),pseudofolliculitis 43 cases(31.85%),erythema nodosum 61 cases(45.19%),nervous system involvement 4 cases(2.96%),vascular involvement 9 cases(6.67%,including aneurysm with venous thrombosis 4 cases,aneurysms 2 cases,each of venous thrombosis,arterial embolism,thrombosis and occlusion accounting for 1 cases),gastrointestinal involvement 12 cases(8.88%,including ileocecal ulcers 6 cases,esophagus ulcers 4 cases),joints involvement29 cases(21.48%),pulmonary interstitial changes 9 cases(6.67%),positivity of skin pathergy test 53 cases(85.48%).In clinical manifestations,it revealed that more vascular involvement was seen in male(P=0.024)and higher joints involvement incidence was found in female patients.Oral ulcers were the most common first symptom(57.78%),followed by oral ulcers with genital ulcers(15.56%),cutaneous lesions(14.81%),fever (5.93%),genital ulcers(2.96%),abdominal pain or distension(1.48%),ocular involvement(0.74%)and joint pain(0.74%).All of results presented above in age group differences were not statistically significant with P>0.05.(3)Laboratory and pathology tests: In laboratory,there were 85 cases with elevated ESR and 89 cases elevated CRP.Ig G levels in female patients was higher than those in males(P=0.032).15 patients was performed by Skin histopathological examination whose pathology was panniculitis 8cases,vasculitis 3 cases,neutrophilic cutaneous reaction 4 cases.(4)BD patients were combined with congenital heart diseases 2 cases,tuberculosis 37 cases,hepatitis 12 cases,thyroid diseases 9 cases,blood system diseases 5 cases,ankylosing spondylitis,nervous system diseases,solid tumors,perianal abscesses and depression 2 cases,respectively.(5)Treatment and prognosis: Treatment of BD depends on the severity of the involvements alone or in combination with thalidomide,corticosteroids,compound glycyrrhizin,immunosuppressors,biological agents,sulfasalazine,immunomodulator and herb.BD patients having thrombosis or embolism were treated with anticoagulants.All patients were improved and discharged.Conclusion:(1)The incidence of BD was common in females and it could arise at any age with a peak of middle-young people and the duration of the disease was different.(2)Recurrent oral ulcer was the most common clinical manifestation and initial presentation.Multiple systems could be involved and had gender differences in clinical manifestations.Vascular involvement had a more course among male patients with common aneurysms.There were more joints lesions in females,especially in knee joints;gastrointestinal involvements appeared in ileocecal ulcers commonly,followed by esophagus ulcers and most of them had digestive tract symptoms.(3)The histopathological features of BD were diversified,most of which were panniculitis expressions.(4)BD could be combined with infectious diseases,autoimmune diseases,blood system diseases and other diseases.(5)Many drugs may treat BD.Patients remaining in serious condition with multiple organs system involvement or having refractory BD or needing surgery were treated effectively with glucocorticoid combined with immune inhibitors or biological agents. |
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