Brain Perfusion MRI Findings in Patients with Behcet's Disease

Objective. To search brain perfusion MRI (pMRI) changes in Behcet's disease (BD) with or without neurological involvement. Materials and Method. The pMRI were performed in 34 patients with BD and 16 healthy controls. Based on neurologic examination and post-contrast MRI, 12 patients were classified as Neuro-Behcet (group 1, NBD) and 22 patients as BD without neurological involvement (group 2). Mean transit time (MTT), time to peak (TTP), relative cerebral blood volume (rCBV), and relative cerebral blood flow (rCBF) were obtained and compared to those of healthy control group (group 3). Results. There was a significant difference in the MTT and rCBF within the pons and parietal cortex in groups 1 and 2. rCBV increased in cerebral pedicle in group 1 compared with groups 2 and 3. In the temporal lobe white matter, prolonged MTT and decreased rCBF were found in groups 1 and 2. In the corpus striatum, internal capsule, and periventricular white matter, rCBF increased in group 1 compared with group 3 and decreased in groups 1 and 2. Conclusion. Brain pMRI is a very sensitive method to detect brain involvement in patients with BD and aids the clinical diagnosis of NBD, especially in patients with negative MRI findings

Psychiatric morbidity in dermatology patients: Frequency and results of consultations

<b>BACKGROUND:</b> Dermatological patients quite commonly depict psychiatric morbidity. <b> PURPOSES:</b> To study the psychiatric morbidity among skin patients of our clinic. <b> METHODS:</b> In the present study, the patients who were treated in the Dermatology Clinic of Inonu University Medical Faculty were evaluated retrospectively. The age, gender, marital status, habits, dermatological and systemic diseases, previously used drugs, current therapy and psychiatric diagnosis of each patient were recorded. <b> FINDINGS:</b> Of 636 patients involved in the study, 15.3&#x0025; had psychopathological problems, which were depression (32.0&#x0025;), adjustment difficulty (15.5&#x0025;), anxiety (13.4&#x0025;), psychosomatic disorders (10.3&#x0025;), obsessive-compulsive disorder and conversion (5.1&#x0025;), dysthymic disorder (4.1&#x0025;), attention deficit and hyperactivity disorder (2.1&#x0025;), panic attack (1.0&#x0025;), premenstrual syndrome, schizophrenia, somatization disorder, insomnia, alcohol dependency, bipolar affective disorder, mental retardation, agoraphobia, social phobia and dementia. The dermatological diseases defined for the patients with psychopathology diagnosis were chronic urticaria (25.8&#x0025;); psoriasis (15.5&#x0025;); alopecia areata, totalis and iniversalis (11.3&#x0025;); acute urticaria, neurodermatitis and Behcet&#x2032;s disease (5.1&#x0025;); atopic dermatitis and drug eruptions (4.1&#x0025;); pemphigus (3.1&#x0025;); angioedema, contact dermatitis and generalized pruritus (2.1&#x0025;); folliculitis and the others (1.0&#x0025;). <b> CONCLUSIONS:</b> Psychiatric morbidity has an affect on the course of dermatological diseases. When required, psychiatric consultation should be sought by dermatology clinics and patients should be followed with the cooperation of dermatologists and psychiatrists. <b> LIMITATION:</b> The indoor-based study had not included any control group and any domicillary patient

Demographic and clinical properties of juvenile-onset Behcet's disease: A controlled multicenter study

WOS: 000254315000003PubMed ID: 18045733Background: Behcet's disease (BD) is a multisystemic inflammatory disorder Of unknown origin. The disease usually occurs between the second and the fourth decades, whereas it is uncommon in children. Objective. In this multicenter study, we aimed to describe the demographic and clinical features along with severity in juvenile- versus adult-onset 131). Methods: Patients with initial symptoms at age 16 years or younger were considered as having juvenileonset 131). In all, 83 patients with juvenile-onset BID (38 male and 45 female; mean age 19.6 +/- 7.6 years) and 536 with adult-onset (>16 years) BD (293 male and 243 female; mean age 39.2 +/- 10.1 years) who fulfilled the classification criteria of the International Study Group for BD were involved in the study. Results: Familial cases were more frequent in juvenile-onset compared with adult-onset BD (19% vs 10.3%; P=.017). The mean age of disease onset was 12.29 +/- 3.54 years in juvenile-onset 131) and 31.66 +/- 8.71 years in adult-onset 131). Mucocutaneous lesions and articular symptoms were the most commonly observed manifestations in both groups. The frequency of disease manifestations was not different between juvenile and adult-onset BID, except neurologic and gastrointestinal involvement, which were higher in juvenileonset 131) than adult-onset BD (P =.027 and P =.024, respectively). Oral ulcer was the most common onset manifestation of both juvenile-onset (86.74%) and adult-onset (89-55%) BD. The frequencies of onset manifestations of 131) were similar, except genital ulcer, which was higher in adult-onset 131) (P =.025). Limitations: Our study consisted of patients with 131) mainly applying to dermatology and venerology departments. Therefore, it can be speculated that this Study includes rather a milder spectrum of the disease. Conclusions: Although the clinical spectrum of juvenile-onset BD seems to be similar to adult-onset BD, the frequency of severe organ involvement was higher. Because of the higher prevalence of familial cases in juvenile-onset BD, it can be speculated that genetic factors may favor early expression of the disease with severe organ involvement

Zależność między stężeniem homocysteiny w surowicy a nieprawidłowościami struktury i czynności tętnic szyjnych w nieaktywnej fazie choroby Behçeta

Background: Behçet’s disease (BD) is a chronic autoimmune disorder with symptoms manifesting from an underlying vasculitis. Since the disease activity is correlated with characteristic vascular endothelial dysfunction, BD places individuals at increased risk of cardiovascular diseases, such as atherosclerosis. Hyperhomocysteinaemia is an independent risk factor for arteriosclerotic vascular diseases. Aim: This study was designed to investigate how plasma homocysteine (Hcy) affects the structural and functional properties of the carotid artery in humans. Methods: Sixty-eight BD patients with subclinical atherosclerosis and 40 healthy controls underwent carotid sonography and Doppler ultrasound to measure carotid artery intima–media thickness (C-IMT) and carotid stiffness and distensibility (indicat­ing elasticity). Total Hcy level was determined by enzyme-linked immunosorbent assay. For analysis, the BD patients were sub-grouped according to hyperhomocysteinaemia (&gt; 15 μmol/L). Results: The patients with BD were found to have increased C-IMT and beta stiffness and decreased distensibility. In addition, hyperhomocysteinaemia was significantly correlated with these detrimental changes in the carotid artery, possibly raising the risk of these patients developing atherosclerosis. Conclusions: These findings suggest a potential mechanism of atherosclerosis in BD and highlight the processes that future research should focus on to address identification and prophylactic treatment of BD patients at risk of cardiovascular disease.Wstęp: Choroba Behçeta (BD) to przewlekłe schorzenie autoimmunologiczne z objawami spowodowanymi zapaleniem naczyń. Ze względu na to, że aktywność choroby wiąże się z charakterystyczną dysfunkcją śródbłonka naczyniowego osoby chore na BD są obciążone zwiększonym ryzykiem chorób sercowo-naczyniowych, takich jak miażdżyca. Hiperhomocysteinemia jest niezależnym czynnikiem ryzyka miażdżycowej choroby naczyń. Cel: Badanie przeprowadzono w celu oceny wpływu stężenia homocysteiny (Hcy) w osoczu na strukturalne i czynnościowe właściwości tętnicy szyjnej u ludzi. Metody: U 68 chorych na BD z subkliniczną miażdżycą oraz u 40 zdrowych osób z grupy kontrolnej wykonano badanie ultrasonograficzne (USG) w celu oceny tętnic szyjnych oraz USG doplerowskie w celu pomiaru grubości kompleksu błony środkowej i wewnętrznej tętnic szyjnych (C-IMT) oraz sztywności i rozszerzalności tych tętnic (świadczących o ich elastyczności). Całkowite stężenie Hcy określono metodą immunoenzymatyczną. Na potrzeby analizy chorych na BD podzielono na podgrupy w zależności od obecności hiperhomocysteinemii (Hcy >15 μmol/l). Wyniki: U chorych na BD stwierdzono zwiększone wartości C-IMT i wskaźnika sztywności tętnic beta oraz zmniejszoną rozszerzalność tętnic. Hiperhomocysteinemia była istotnie skorelowana z tymi niekorzystnymi zmianami w tętnicach szyjnych, potencjalnie zwiększającymi ryzyko rozwoju miażdżycy u tych pacjentów. Wnioski: Uzyskane wyniki wskazują na możliwy mechanizm rozwoju miażdżycy u chorych na BD i zwracają uwagę na procesy, na których należy się skupić w przyszłych badaniach dotyczących identyfikacji pacjentów z BD zagrożonych rozwojem chorób sercowo-naczyniowych i odpowiedniego leczenia profilaktycznego w tej grupie osób