Does lowering hyperhomocysteinemia by folic acid beneficial for oculo-Behcet's disease? A pilot study.
OBJECTIVE
To determine the effect of folic acid supplementation in Behçet's disease (BD) patients with ocular involvement associated with hyperhomocysteinemia (Hhcys).


METHODS
19 BD patients, all with uveitis and/or retinal vasculitis associated with Hhcys (plasma hcy > 15 micromol/l) were prospectively included. Patients were divided into 2 groups. Group 1 consisted of 11 patients that received folic acide (15 mg/d) in addition to their previous standard treatment. Group 2 included 8 patients treated only with their previous standard treatment. Visual acuity and uveitis attacks were assessed initially and monthly at each visit in all groups. Mean Visual acuity and frequency of uveitis attacks were evaluated quarterly.


RESULTS
In group 1, the mean plasma hcys level was significantly lower after than before the treatment period (27.7 vs 13.1 micromol/l; p= 0.04) while it did not vary significantly in the same period in Group 2 patients. Frequency of uveitis attacks was significantly lower after than before treatment at each quarter in groupl and mean visual acuity in this group increased from 4.33 to 5.44 decimals. During the treatment period, the mean number of uveitis attacks, converted to frequency per 12 months were significantly lower in group 1 than in group 2. During this period, the VA slightly increased in group 1 and decreased in group 2 but the difference was not significant.


CONCLUSIONS
Our results indicate that folates supplementation is useful for BD patients with Hhcys.
Houman
Mohamed H
MH
Department of Internal Medicine, La Rabta Hospital and Behçet's disease unit Research, faculty of medicine, Tunis, Tunisia.
Naffati
Hajer
H
Khanfir
Monia
M
Ghannouchi
Mahdi
M
Ben Ghorbel
Imed
I
Lamloum
Mounir
M
El Matri
Leila
L
Hamzaoui
Kamel
K
Jeddi
Amel
A
Miled
Mohamed
M
Fki
Moncef
M
D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000328:Adult; D000368:Aged; D001528:Behcet Syndrome / Q000188:drug therapy*; D003520:Cyclophosphamide / Q000627:therapeutic use; D005260:Female; D005492:Folic Acid / Q000627:therapeutic use*; D005500:Follow-Up Studies; D006710:Homocysteine / Q000097:blood; D006801:Humans; D020138:Hyperhomocysteinemia / Q000097:blood / Q000188:drug therapy*; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011446:Prospective Studies; D031300:Retinal Vasculitis / Q000188:drug therapy; D014605:Uveitis / Q000188:drug therapy; D014792:Visual Acuity / Q000502:physiology; D014803:Vitamin B Complex / Q000627:therapeutic use*
D000305:Adrenal Cortex Hormones; D007166:Immunosuppressive Agents; D006710:Homocysteine; D014803:Vitamin B Complex; D003520:Cyclophosphamide; D005492:Folic Acid