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Behçet’s disease in Egypt: a multicenter nationwide study on 1526 adult patients and review of the literature

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A Correction to this article was published on 13 July 2019

This article has been updated

Abstract

Objectives

The present work was conducted to estimate the prevalence of adult Behçet’s disease (BD) in adult Egyptian and to study the clinical pattern and influence of age at-onset and sex on disease phenotype. Also, we investigated the spectrum of presentation and frequencies along the north-to-south gradient of the country.

Patients and method

The population-based, multicenter, cross-sectional study included 1526 adult BD patients from 26 specialized Egyptian rheumatology centers. Demographic, clinical, and therapeutic data are assessed for all patients.

Results

The mean age of patients was 35.7 ± 9.84 years, disease duration 6.58 ± 5.25 years, and age at onset 29.37 ± 8.6 years; 91 were juvenile-onset (JoBD). There were 1102 males and 424 females (M:F 2.6:1). Regarding co-morbidities, 19.92% were diabetic, and 26.05% were hypertensive. The mean body mass index was 27.57 ± 5.24 (43.1% overweight; 25.9% obese). The mean BD current activity form was 4.48 ± 4.28. Regarding the medications use, systemic steroid and colchicine were the most common drugs used (947 (90.2%) and 611 (82.7%), respectively). The overall estimated prevalence of BD in Egypt was 3.6/100,000 population being highest in the two main cities: Alexandria (15.27) and Cairo (8.72). Pathergy test was positive in 43.4%. 90.2% were receiving systemic steroids and 8.3%, biologics. Disease characteristics were comparable between JoBD and adult-onset BD cases. Central nervous system (CNS), deep venous thrombosis (DVT), and gastrointestinal (GIT) involvement were significantly higher in males (p = 0.01, p = 0.001, and p = 0.001 respectively) while joint affection (p = 0.001) and disease activity (p = 0.011) were increased in females.

Conclusions

This study provides current prevalence of BD in Egypt; 3.6/100,000 with no remarkable north-to-south gradient. The sex influences the disease phenotype with the CNS, DVT, and GIT involvement are higher in males, while the joint affection and disease activity were increased in females.

Key Points

• The prevalence and phenotype of Behçet’s disease across Egypt is presented in a multicenter nationwide study.

• The potential influence of the age at onset and sex on disease phenotype is highlightened.

• A review of the literature worldwide is presented allowing comparisons with studies from other nations.

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Change history

  • 13 July 2019

    The author wishes to correct the record and clarify that in the original version of this article in the Discussion section under “Prevalence over the country governorates” inadvertently presented incorrect data cited in the reference [30].

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Authors and Affiliations

  1. Rheumatology Department, Faculty of Medicine, Cairo University, Cairo, Egypt

    Tamer A. Gheita, Iman I. El-Gazzar & Nahla N. Eesa

  2. Ophthalmology Department, Faculty of Medicine, Alexandria University, Alexandria, Egypt

    Eiman Abd El-Latif

  3. Internal Medicine Department, Rheumatology Unit, Faculty of Medicine, Ain-Shams University, Cairo, Egypt

    Nermeen Samy & Nermeen Noshy

  4. Rheumatology Department, Faculty of Medicine, Assuit University, Assuit, Egypt

    Nevin Hammam

  5. Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada

    Nevin Hammam

  6. Internal Medicine Department, Rheumatology Unit, Tanta University, Tanta, Gharbia, Egypt

    Rasha A. Abdel Noor

  7. Internal Medicine Department, Rheumatology Unit, Menoufia University, Shebeen El-Kom, Menoufia, Egypt

    Emad El-Shebeiny

  8. Rheumatology Department, Faculty of Medicine, Zagazig University, Zagazig, Sharkia, Egypt

    Amany R. El-Najjar

  9. Internal Medicine Department, Rheumatology Unit, Faculty of Medicine, Beni-Suef University, Beni-Suef, Egypt

    Mohamed N. Salem

  10. Rheumatology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt

    Soha E. Ibrahim

  11. Internal Medicine Department, Rheumatology Unit (NCRRT), Atomic Energy Authority (AEA), Cairo, Egypt

    Dina F. El-Essawi

  12. Rheumatology Department, Faculty of Medicine, Sohag University, Sohag, Egypt

    Ahmed M. Elsaman

  13. Rheumatology Department, Faculty of Medicine, Fayoum University, Fayoum, Egypt

    Hanan M. Fathi

  14. Rheumatology Department, Faculty of Medicine, Mansoura University, Mansoura, Dakahlia, Egypt

    Rehab A. Sallam

  15. Rheumatology Department, Faculty of Medicine, Minia University, Minia, Egypt

    Rawhya R. El-Shereef

  16. Rheumatology Department, Faculty of Medicine, Beni-Suef University, Beni-Suef, Egypt

    Mervat I. Abd-Elazeem

  17. Rheumatology Department, Faculty of Medicine, Benha University, Benha, Kalubia, Egypt

    Emtethal A. Said & Rasha M. Fawzy

  18. Internal Medicine Department, Rheumatology Unit, Faculty of Medicine, Cairo University, Cairo, Egypt

    Noha M. Khalil

  19. Internal Medicine Department, Rheumatology Unit, Faculty of Medicine, Mansoura University, Mansoura, Dakahlia, Egypt

    Dina Shahin

  20. Rheumatology Department, Faculty of Medicine, Tanta University, Tanta, Egypt

    Hanan M. El-Saadany

  21. Internal Medicine Department, Rheumatology Unit, Faculty of Medicine, Alexandria University, Alexandria, Egypt

    Marwa S. ElKhalifa

  22. Rheumatology Department, Faculty of Medicine, Suez-Canal University, Ismailia, Egypt

    Samah I. Nasef

  23. Rheumatology Department, Faculty of Medicine, Aswan University, Aswan, Egypt

    Ahmed M. Abdalla

  24. Internal Medicine Department III, Division of Rheumatology, Medical University of Vienna, Vienna, Austria

    Ahmed M. Abdalla

  25. Rheumatology Department, Faculty of Medicine, South Valley University, Qena, Egypt

    Ehab Saad

  26. Rheumatology Department, Faculty of Medicine, Al-Azhar University, Assuit, Egypt

    Abdel-Hafeez Moshrif

  27. Rheumatology Department, Faculty of Medicine, Menoufia University, Shebeen El-Kom, Menoufia, Egypt

    Amira T. El-Shanawany

  28. Rheumatology Department, Faculty of Medicine, Alexandria University, Alexandria, Egypt

    Yousra H. Abdel-Fattah

  29. Ophthalmology Department, Faculty of Medicine, Beni-Suef University, Beni-Suef, Egypt

    Hossam M. Khalil

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  1. Tamer A. Gheita
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  18. Emtethal A. Said
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  29. Amira T. El-Shanawany
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  30. Yousra H. Abdel-Fattah
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Egyptian College of Rheumatology-Behçet’s Disease Study Group (ECR-BDSG)

Corresponding author

Correspondence to Tamer A. Gheita.

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Gheita, T.A., El-Latif, E.A., El-Gazzar, I.I. et al. Behçet’s disease in Egypt: a multicenter nationwide study on 1526 adult patients and review of the literature. Clin Rheumatol 38, 2565–2575 (2019). https://doi.org/10.1007/s10067-019-04570-w

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  • DOI: https://doi.org/10.1007/s10067-019-04570-w

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