Arromdee Emvalee, Tanakitivirul Maneerat
Division of Rheumatology, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
J Med Assoc Thai. 2006 Nov;89 Suppl 5:S182-6.
To describe symptoms, signs, laboratory findings and to compare sensitivity of several classification criteria in Thai patients who were diagnosed with Behcet's disease.
Using medical records from the rheumatology unit, Siriraj hospital, all cases diagnosed with Behcet's disease by our rheumatology staff were identified and reviewed. Demographic data, clinical presentations, and laboratory data were collected. All cases were also reviewed if they had fulfilled any of the following criteria: Iran classification tree, Japanese, Korean, ISG and O'Duffy's criteria. The sensitivity of each criterion was calculated.
Twenty three cases were identified during a 24 year interval (1980-2003). Our population had a mean age of 30.83 years. Common clinical presentations were recurrent oral ulcers 100% (23/23), genital ulcers 69.6% (16/23), eye involvement 52.2% (12/23), skin involvement 60.9% (14/23), GI ulcers 8.7% (2/23), epididymitis 4.3% (1/23), vascular lesions 8.7% (2/23), CNS involvement 8.7% (2/23), fever 60.9% (14/23), and positivity of the pathergy test 33.3% (3/9). The sensitivity of criteria used for diagnosis of our patients with Behcet's disease varied widely. We found that the Iran classification tree criteria had the highest sensitivity followed by those from Japan (82.6%), O'Duffy's (73.9%), ISG (52.2%), and Korean (39.1%o) criteria respectively.
Behcet's disease is heterogeneous in its manifestations and clinical constellation of the disease varies widely among different parts of the world. This is the first epidemiologic study describing Thai Behcet's patients. We also found the Iran classification tree criteria had the highest sensitivity for diagnosis of Thai patients.
描述泰国白塞病患者的症状、体征、实验室检查结果,并比较几种分类标准的敏感性。
利用诗里拉吉医院风湿病科的病历,对所有经风湿病科工作人员诊断为白塞病的病例进行识别和回顾。收集人口统计学数据、临床表现和实验室数据。所有病例还需检查是否符合以下任何一项标准:伊朗分类树状标准、日本标准、韩国标准、国际白塞病研究组(ISG)标准和奥达菲标准。计算每个标准的敏感性。
在24年期间(1980 - 2003年)共识别出23例病例。我们的研究对象平均年龄为30.83岁。常见临床表现为复发性口腔溃疡100%(23/23)、生殖器溃疡69.6%(16/23)、眼部受累52.2%(12/23)、皮肤受累60.9%(14/23)、胃肠道溃疡8.7%(2/23)、附睾炎4.3%(1/23)、血管病变8.7%(2/23)、中枢神经系统受累8.7%(2/23)、发热60.9%(14/23)、针刺反应阳性33.3%(3/9)。用于诊断我们的白塞病患者的标准敏感性差异很大。我们发现伊朗分类树状标准敏感性最高,其次是日本标准(82.6%)、奥达菲标准(73.9%)、ISG标准(52.2%)和韩国标准(39.1%)。
白塞病的表现具有异质性,且疾病的临床症状在世界不同地区差异很大。这是第一项描述泰国白塞病患者的流行病学研究。我们还发现伊朗分类树状标准对泰国患者诊断的敏感性最高。