Late-onset Behçet's disease does not correlate with indolent clinical course: report of seven Taiwanese patients.
BACKGROUND
Behçet's disease (BD) is a recurrent multisystem disease of uncertain aetiology. The young adults are most often affected, usually during the third decade. Late occurrence of the disease is considered uncommon and less frequently investigated.


OBJECTIVE
The aim of this study was to examine the clinical features of BD patients with disease onset at a later age and compare them with the usual age of onset group.


METHODS
Retrospective review of clinical charts of BD patients was conducted. Patients with age of onset at or after 40 years of age were identified. The clinical profiles and medications required to control the disease activity were documented. Comparisons of clinical features and the medications used were made between patients with disease onset before and after 40 years of age.


RESULTS
Seven late-onset BD patients were identified. Among them, five patients required the use of systemic immunosuppressant in addition to colchicine and corticosteroid for adequate disease control. There is no significant difference in clinical profiles between patients with disease onset before and after 40 years of age, but the incidence of uveitis, an indicator of unfavourable prognosis, was surprisingly high. More specifically, it was noted in four of seven patients identified.


CONCLUSIONS
Our findings indicate that the clinical course of BD is not indolent in the patients with late-onset BD. More importantly, physicians should be aware that BD can occur in older patients, and close attention regarding their disease activities is warranted as their clinical courses may not be as benign as previously believed.
Tsai
J
J
Department of Dermatology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
Chen
G-S
GS
Lu
Y-W
YW
Wu
C-S
CS
Lan
C-C E
CC
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use*; D000328:Adult; D017668:Age of Onset; D001528:Behcet Syndrome / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology*; D003078:Colchicine / Q000627:therapeutic use*; D018450:Disease Progression; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013624:Taiwan; D016896:Treatment Outcome; D014605:Uveitis / Q000209:etiology
D000305:Adrenal Cortex Hormones; D007166:Immunosuppressive Agents; D003078:Colchicine