Akyol Lütfi, Günbey Emre, Karlı Rıfat, Önem Soner, Özgen Metin, Sayarlıoğlu Mehmet
Division of Rheumatology, Department of Internal Medicine, Ondokuz Mayıs University School of Medicine, Samsun, Turkey.
Department of Otolaryngology, Ondokuz Mayıs University School of Medicine, Samsun, Turkey.
Eur J Rheumatol. 2016 Dec;3(4):153-156. doi: 10.5152/eurjrheum.2016.017. Epub 2016 Dec 1.
Behçet's disease (BD) is a chronic, relapsing type of vasculitis of unknown etiology and is characterized by oral and urogenital ulcers and ocular inflammation with cutaneous, musculoskeletal, vascular, and nervous system manifestations. Few cases involving the nasal mucosa have been reported in the literature, and the true prevalence of BD remains unknown. Neurological involvement associated with BD might play a more important role in causing olfactory dysfunction than mucosal involvement, but sufficient clinical data are not available on the effect of BD on olfaction in adults. We therefore evaluated the olfactory function of patients diagnosed with BD.
Patients were chosen from among a consecutive patient group population who visited the internal medicine rheumatology polyclinic and otolaryngology departments of Ondokuz Mayıs University Hospital. A total of 50 patients (both males and females) aged 18 to 60 years with a diagnosis of BD and 46 healthy controls (matched to the study group in terms of age and gender) were included. BD was diagnosed based on the criteria defined by the International Study Group for BD. A complete clinical history was taken for and a physical examination was performed in all participants. Patients with other rheumatic diseases; obstructive nasal pathologies leading to conductive-type olfactory dysfunction (e.g., septum deviation or nasal polyp); advanced systemic disease (e.g., hypertension or malignancy); a history of antithyroid, antihistamine, antidepressant, or steroid medication use within the past month; or who were current smokers, had an active upper respiratory infection, or had a history of otolaryngologic operations were excluded. The results of the "Sniffin' Sticks" (SS) olfactory test were compared between the two groups.
The mean age of the 50 BD patients was 35.3±10 years; that of the 46 health controls was 36.9±11 years. There was no significant group difference in age or gender distribution (p>0.05). Odor identification and overall scores were significantly lower in the BD group than in the control group. There were no significant differences in odor discrimination scores between the BD and control groups (p>0.05).
To our knowledge, this is the first study to evaluate olfactory function in patients diagnosed with BD using the SS test. Odor identification was more impaired in BD patients than in healthy controls, but there was no group difference in odor discrimination. BD patients should also be assessed for the involvement of olfactory function and may require treatment due to a malfunction of the olfactory system that affects the quality of life.
白塞病（BD）是一种病因不明的慢性复发性血管炎，其特征为口腔和生殖器溃疡以及眼部炎症，并伴有皮肤、肌肉骨骼、血管和神经系统表现。文献中报道的涉及鼻黏膜的病例很少，BD的真实患病率仍然未知。与BD相关的神经受累在导致嗅觉功能障碍方面可能比黏膜受累起更重要的作用，但关于BD对成人嗅觉影响的充分临床数据尚不可得。因此，我们评估了被诊断为BD的患者的嗅觉功能。
从访问了于斯屈达尔医科大学医院内科风湿病多学科门诊和耳鼻喉科的连续患者群体中选取患者。共纳入50例年龄在18至60岁之间、诊断为BD的患者（男女均有）以及46名健康对照者（在年龄和性别方面与研究组匹配）。BD根据国际白塞病研究组定义的标准进行诊断。对所有参与者进行了完整的临床病史采集和体格检查。排除患有其他风湿性疾病、导致传导性嗅觉功能障碍的阻塞性鼻病（如鼻中隔偏曲或鼻息肉）、晚期全身性疾病（如高血压或恶性肿瘤）、在过去一个月内有抗甲状腺、抗组胺、抗抑郁或类固醇药物使用史、或为当前吸烟者、患有活动性上呼吸道感染或有耳鼻喉科手术史的患者。比较了两组之间“嗅觉棒”（SS）嗅觉测试的结果。
50例BD患者的平均年龄为35.3±10岁；46名健康对照者的平均年龄为36.9±11岁。两组在年龄或性别分布上无显著差异（p>0.05）。BD组的气味识别和总体得分显著低于对照组。BD组和对照组之间的气味辨别得分无显著差异（p>0.05）。
据我们所知，这是第一项使用SS测试评估被诊断为BD的患者嗅觉功能的研究。BD患者的气味识别比健康对照者受损更严重，但在气味辨别方面两组无差异。BD患者还应评估嗅觉功能受累情况，并且由于嗅觉系统功能障碍影响生活质量，可能需要进行治疗。
