Behçet's disease in southern Chinese patients.
OBJECTIVE
To describe the clinical characteristics of Behçet's disease (BD) in a southern Chinese population and compare them with those reported in other ethnic groups.


METHODS
Patients with BD from 4 large regional hospitals in Hong Kong were identified from the hospital information retrieval system. Their records were retrospectively reviewed and the diagnosis was verified by at least 2 rheumatologists using the International Study Group (ISG) criteria. Demographic data and various clinical features of our patients were collected and analyzed.


RESULTS
Between 1978 and 2000, 37 adult patients with definite BD according to the ISG criteria were identified. All patients were ethnic southern Chinese. There were 19 women and 18 men (F:M = 1.1:1). The mean age at diagnosis was 36.2 +/- 10 (18-74) years. Presenting features at diagnosis, in decreasing order of frequency, were oral ulceration (100%), genital ulceration (81%), skin lesions (73%), arthritis/arthralgia (54%), and ocular lesions (35%). Among skin lesions, the commonest manifestations were erythema nodosum (74%), folliculitis (44%), and acneiform nodules (30%). Arthritis was usually polyarticular (75%) and symmetrical, and involved the upper limb joints. Anterior uveitis was the most common ocular complication (77%) and was often bilateral. Involvement of other systems such as the central nervous system, gastrointestinal (GI) tract, and cardiopulmonary system was uncommon. Vascular complications were rare. Only 2 (6%) patients had a positive pathergy test. Our patients were followed for a mean of 59.9 +/- 52 months. Apart from recurrent attacks of orogenital ulceration and uveitis, new systemic features were unusual. One patient died of bowel perforation as a result of active GI disease. Compared with other reported series, our patients had fewer ocular and systemic manifestations, and a significantly lower incidence of the pathergy reaction.


CONCLUSIONS
BD is rare among southern Chinese in Hong Kong and tends to run a more benign course with less systemic involvement and fewer serious ocular complications. Whether the observed difference in clinical manifestations of the disease is related to a different HLA association or environmental factors warrants further studies.
Department of Medicine and Geriatrics, Tuen Mun Hospital, New Territories, Hong Kong, SAR, China. ccmok@netvigator.com
Chi Chiu
CC
Mok
Tak Cheong
TC
Cheung
Carmen Tse Kwan
CT
Ho
Ka Wing
KW
Lee
Chak Sing
CS
Lau
Raymond Woon Sing
RW
Wong
D000293:Adolescent; D000328:Adult; D000368:Aged; D001528:Behcet Syndrome / Q000208:ethnology* / Q000473:pathology; D002681:China / Q000208:ethnology; D005006:Ethnicity; D005260:Female; D006723:Hong Kong / Q000453:epidemiology; D006767:Hospitals, District; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies