title: Behçet's disease‬ and familial Mediterranean fever: Two sides of the same coin or just an association? A cross-sectional study‬.
abstract: BACKGROUND
  Familial Mediterranean fever (FMF) is a genetic disease, characterized by attacks of fever, arthritis, serositis and pain. Behçet's disease (BD) is an inflammatory disorder with a genetic basis, characterized by oral and genital ulcers, uveitis, pustular erythematous cutaneous lesions, arthritis, central nervous system involvement and possible vascular manifestations such as venous thrombosis, arteritis and aneurysms.
  
  
  OBJECTIVE
  To investigate the association and actual differentiation between these two entities in a large-scale population-based study.
  
  
  METHODS
  Data for this study was collected from the databases of "Clalit Health Services", the largest state-mandated health service organization in Israel. All adult members diagnosed with BD were included (n=892) and as well as their age- and sex-matched controls (n=4444), creating a cross-sectional population-based study. Medical records of all subjects were analyzed for documented FMF. A logistic regression model was done to estimate how BD, age, gender, BMI, ethnicity and socioeconomic status contributed as risk factors for FMF.
  
  
  RESULTS
  The proportion of FMF in patients with BD increased compared with those reported in controls (5.83% and 0.23%, respectively, P<0.001). This coexistence was prominent among both sex groups but was much stronger among female BD patients (females with OR of 177 and of 8.4 in males, P<0.001). In a multivariate analysis, BD was identified as an independent risk factor for FMF (OR 25.16, 95% CI 13-53.3).
  
  
  CONCLUSIONS
  BD diagnosis was found to be independently associated with higher incidence of FMF, especially in females, people of Arab descent and BMI>30. Our data imply that understating the differentiation between FMF and BD is not evident and clear in a real-life population of patients with BD.
authors: Department of Medicine 'B', Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel-Hashomer, Israel; Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
authors: Abdulla
authors: A
authors: Watad
authors: Department of Medicine 'B', Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel-Hashomer, Israel; Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
authors: Shmuel
authors: S
authors: Tiosano
authors: Department of Medicine 'B', Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel-Hashomer, Israel; Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
authors: Dana
authors: D
authors: Yahav
authors: Chief Physician's Office, Clalit Health Services, Tel-Aviv, Israel.
authors: Doron
authors: D
authors: Comaneshter
authors: Department of Medicine 'B', Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel-Hashomer, Israel; Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
authors: Yehuda
authors: Y
authors: Shoenfeld
authors: Chief Physician's Office, Clalit Health Services, Tel-Aviv, Israel; Siaal Research Center for Family Medicine and Primary Care, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
authors: Arnon D
authors: AD
authors: Cohen
authors: Department of Medicine 'B', Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel-Hashomer, Israel; Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel. Electronic address: howard.amital@sheba.health.gov.il.
authors: Howard
authors: H
authors: Amital
mesh_terms: D000293:Adolescent; D000328:Adult; D018912:Arabs / Q000235:genetics*; D001528:Behcet Syndrome / Q000453:epidemiology* / Q000235:genetics; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D016208:Databases, Factual; D010505:Familial Mediterranean Fever / Q000453:epidemiology* / Q000235:genetics; D005260:Female; D020022:Genetic Predisposition to Disease; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007557:Israel / Q000453:epidemiology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009154:Mutation; D000071198:Pyrin / Q000235:genetics; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors; D055815:Young Adult
chemical_list: C000604192:MEFV protein, human; D000071198:Pyrin
keywords: Behçet's disease; Comorbidity; FMF; Fever; MEFV gene