Objectives Vascular involvement, especially in young males, is one of the main causes of mortality and morbidity in Behcet's Disease (BD). However, the prognosis and predictors of vascular involvement is unsufficiently studied in the literature. In this study, we aimed to follow-up male BD patients without major organ involvement, prospectively. Subclinical vascular involvement and markers of endothelial dysfunction (ADMA, E-selectin and VWF levels) in these patients is also investigated.
Methods Thirty-six male patients with BD, 35 males with ankylosing spondylitis and 36 healthy males were included into the study. Bilateral upper and lower extremity venous doppler ultrasonography (US) and brachial and carotid arterial US were performed in baseline visit for all study groups and in the first year follow-up visit for BD patients. Serum samples were also taken to analyse ADMA, E-selectin and VWF levels. The same protocol was also applied to all patients coming with an emergency visit for acute vascular events.
Results The rate of venous insufficiency was significantly higher in male BD patients without vascular events, compared to healthy controls. Immunsuppresive (IS) therapy was required in 22% (n=8) of patients with BD in the follow-up period (mean 20.6 months). The cause of IS therapy was major organ involvement in 4 (11%, 3 vascular and 1 ocular involvement) patients and refractory mucocutaneous symptoms in other 4 (11%) patients. Markers of endothelial dysfunction (FMD and NID) were similar between BD patients and healthy controls, however CIMT (Carotid intima media thickness) was significantly higher in BD. In first year follow-up visit, endothelial functions and CIMT were observed to be significantly improved compared to baseline. Serum VWF levels were also significantly higher in BD, whereas ADMA and E-selectin levels were similar between BD patients and healthy controls.
Conclusions Preliminary results of our study (which will be a long-term cohort) demonstrated a lower incidence of major vascular events in male BD patients during prospective follow-up, compared to historic controls in the literature. Although we could not show an impaired endothelial function in BD patients without vascular events, the decreased rate of baseline FMD in patients with later IS requirement, suggest that FMD can be a predictor for major organ involvement in BD.
Disclosure of Interest None declared
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