Background Disease activity evaluation in Behcet’s Disease (BD) needs to be based on the clinical features due to thefluctuating course of the disease and absence of reliable laboratory indices that are useful in reflecting overall disease activity. Previous studies with conflicting results on the relationship between clinical disease activity and acute phase response present highly heterogeneity in the design of the investigations.
Objectives The aim of this study was to evaluate a possible relation between acute phase reactants including ferritin, prealbumin, fibrinogen, haptoglobin (Hp), ceruloplasmin (Cp) and BD clinical disease activity determined by a scale validated.
Methods Seventy eight patients with BD were included in our study. Disease activity was evaluated with “BD Current Activity Form” (BDCAF) which offers an easy-to-complete, valid and reliable method of assessing disease activity in BD. With this form, headache, mouth-genital ulceration, erythema, skin pustules, arthralgia, arthritis, new involvements in gastrointestinal system (GIS), eye, nervous system, major vessels and patient’-physician’s assessments of the overall disease activity scores were analyzed. The levels of serum ferritin, Cp, prealbumin, Hp and plasma fibrinogen of the patients were also measured. The independent samples t test and Pearson’s correlation test were used to analyze the data.
Results There were 42 female and 31 male patients with an age range of 18-54 years. In the comparison of laboratory parameters of the patients with or without the components of BDCAF, no significant relation could be found between headache, erythema nodosum, superficial thrombophlebitis, skin pustules, GIS and eye involvement and acute phase response parameters. However, we found significantly higher levels of ferritin in patients with arthritis and higher levels of fibrinogen in patients both with arthralgia and arthritis versus without joint involvement (p=0,01; p=0,030 and p=0,000; respectively). Also Hp levels in patients with genital ulceration and arthritis (p=0,005 and p=0,002) and Cp levels in patients with oral ulceration and arthritis were found to be higher compared to patients without these involvements (p=0,01 and p=0,001). Prealbumin as a negative acute phase reactant was determined as significantly lower in patients with joint involvement than the patients without it (p=0,023). There were also significant positive correlations between fibrinogen levels and clinician’s overall perception of disease activity and BDCAF total score (p=0,012 and p=0,01; respectively).
Conclusions In conclusion; althoughthere is no specific laboratory profile to determine disease activity in BD, presence of a new developed oral- genital ulceration may be associated with higher levels Cp and Hp. Joint involvement seems to be a prominent clinical feature representing relationships with acute phase response. Relations between disease activity scores and acute phase response, mainly fibrinogen, may contribute the overall disease activity perception in BD.
Disclosure of Interest None Declared