title: Frequent oral ulceration during early disease may predict a severe disease course in males with Behçet's syndrome.
abstract: OBJECTIVE
  The numbers and recurrence rates of mucocutaneous manifestations can be highly variable among patients with Behçet's syndrome (BS) but it is not known whether these differences influence the disease course at the long-term.
  
  
  METHODS
  We evaluated the outcome of 30 patients that made up the placebo arm of a 6 months controlled trial of thalidomide and looked at the relation between the frequencies of mucocutaneous manifestations during the trial and the development of major organ involvement necessitating immunosuppressives during the post-trial period.
  
  
  RESULTS
  Fifteen (50%) patients had received immunosuppresives for major organ involvement during the post-trial period. Patients receiving immunosuppressive treatment were significantly younger at the onset of BS compared to those who did not (24.5±5 vs. 29.7±3.8 SD years; p=0.003). The mean number of oral ulcers recorded throughout the trial was significantly higher among patients using immunosuppressives compared to those who did not (2.09±0.96 vs. 1.43±0.8; p=0.029). This significance disappeared when adjusted for age of onset of BS (p=0.16). ROC curve analysis showed that having 10 or more ulcers during 6 months has a sensitivity of 86.7% and a specificity of 53% for the subsequent necessity of immunosuppressive use. The same association was not true for genital ulcers, follicular lesions and erythema nodosum.
  
  
  CONCLUSIONS
  These findings on a limited number of patients suggest that frequent occurrence of oral ulceration during the initial years of the disease may predict the development of major organ involvement in men with BS.
authors.affiliation: Division of Rheumatology, Department of Internal Medicine, Cerrahpasa Medical School, Istanbul University, Turkey. vhamuryudan@yahoo.com
authors.forename: V
authors.initials: V
authors.lastname: Hamuryudan
authors.forename: G
authors.initials: G
authors.lastname: Hatemi
authors.forename: N
authors.initials: N
authors.lastname: Sut
authors.forename: S
authors.initials: S
authors.lastname: Ugurlu
authors.forename: S
authors.initials: S
authors.lastname: Yurdakul
authors.forename: H
authors.initials: H
authors.lastname: Yazici
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D001528:Behcet Syndrome / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D016009:Chi-Square Distribution; D018450:Disease Progression; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008297:Male; D019226:Oral Ulcer / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D011379:Prognosis; D012372:ROC Curve; D012008:Recurrence; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D012737:Sex Factors; D013792:Thalidomide / Q000627:therapeutic use; D013997:Time Factors; D014421:Turkey; D055815:Young Adult
chemical_list: D007166:Immunosuppressive Agents; D013792:Thalidomide