title: The association between the parenchymal neurological involvement and posterior uveitis in Behçet's syndrome.
abstract: OBJECTIVE
  Behçet's syndrome (BS) is a systemic vasculitis, which may involve multiple organ systems simultaneously. Clinical findings in BS often fit into well-recognized patterns, such as the association between papulo-pustular skin lesions and arthritis. We have recently observed a distinct pattern, in which a subtype of neuro-Behçet's syndrome (NBS) is often preceded by specific ophthalmic manifestations of the disease process. The purpose of this study is to evaluate the association between the parenchymal subtype of NBS and posterior uveitis (PU).
  
  
  METHODS
  We have retrospectively reviewed the clinical records of 295 patients with BS, who met the international classification criteria for BS, diagnosed at two major rheumatology clinics from 2010 to 2014. Patient demographics, ophthalmic examinations, clinical and radiologic patterns of neurological involvement were recorded. Manifestations of BS were classified as PU, NBS, vascular involvement, and arthritis. The association between clinical findings was analysed for statistical significance.
  
  
  RESULTS
  Of the 295 patients, 100 had PU and 44 had NBS. 30 patients had parenchymal NBS and 14 had vascular NBS. Patients with PU were significantly more likely to have neurological involvement compared to those without PU (p<0.001; Odds Ratio: 3.924; 95% CI: 1.786-8.621). Rate of posterior uveitis was higher in patients with parenchymal NBS when compared to patients with vascular NBS, vascular BS or arthritis (63.3%, 21.4%, 22% and 4.2% respectively, p<0.001).
  
  
  CONCLUSIONS
  Our findings suggest a clinically and statistically significant association between posterior uveitis and parenchymal type of neurologic involvement in BS. The development of posterior uveitis in a patient with previously diagnosed BS should be recognized as a "warning sign" for predisposition to neurologic involvement. These patients should be informed about the possible signs and symptoms of neurological involvement, which can cause very rapid and irreversible damage unless recognized and treated immediately.
authors: Department of Internal Medicine/Rheumatology, Ankara Education and Research Hospital, Ankara, Turkey. berivanbitik@hotmail.com.
authors: Berivan
authors: B
authors: Bitik
authors: Department of Internal Medicine/Rheumatology, Gazi University Faculty of Medicine, Ankara, Turkey.
authors: Abdurrahman
authors: A
authors: Tufan
authors: Department of Internal Medicine/Rheumatology, Numune Education and Research Hospital, Ankara, Turkey.
authors: Kubilay
authors: K
authors: Sahin
authors: Department of Neurology, Numune Education and Research Hospital, Ankara, Turkey.
authors: Yesim
authors: Y
authors: Sucullu Karadag
authors: Department of Internal Medicine/Rheumatology, Numune Education and Research Hospital, Ankara, Turkey.
authors: Sevinc
authors: S
authors: Can Sandikci
authors: Department of Internal Medicine/Rheumatology, Gazi University Faculty of Medicine, Ankara, Turkey.
authors: Ridvan
authors: R
authors: Mercan
authors: Department of Neurology, Numune Education and Research Hospital, Ankara, Turkey.
authors: Fikri
authors: F
authors: Ak
authors: Department of Internal Medicine/Rheumatology, Numune Education and Research Hospital; and Department of Internal Medicine/Rheumatology, Hitit University School of Medicine, Ankara, Turkey.
authors: Yasar
authors: Y
authors: Karaaslan
authors: Department of Internal Medicine/Rheumatology, Gazi University Faculty of Medicine, Ankara, Turkey.
authors: Mehmet Akif
authors: MA
authors: Ozturk
authors: Department of Internal Medicine/Rheumatology, Gazi University Faculty of Medicine, Ankara, Turkey.
authors: Berna
authors: B
authors: Goker
authors: Department of Internal Medicine/Rheumatology, Gazi University Faculty of Medicine, Ankara, Turkey.
authors: Seminur
authors: S
authors: Haznedaroglu
mesh_terms: D000328:Adult; D001528:Behcet Syndrome / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D016009:Chi-Square Distribution; D018450:Disease Progression; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D009422:Nervous System Diseases / Q000175:diagnosis / Q000209:etiology*; D016017:Odds Ratio; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D015866:Uveitis, Posterior / Q000175:diagnosis / Q000209:etiology*
chemical_list: D007166:Immunosuppressive Agents