Behçet’s disease in Iraq: new insights into the clinical and epidemiologic features in Middle-Euphrates region

ABSTRACT

Objectives: Behçet’s disease (BD) is a chronic multisystem disease that is classified as a vasculitis. Recent evidence shows that BD is an inflammatory disease at the crossroad between autoinflammatory and autoimmune syndromes. The objective of this study was to determine BD awareness in Iraq, assess the demographic variables, and observe the initial and major clinical manifestations.

Methods: A cross-sectional study was conducted, including 105 patients, aged between 15 and 60 (mean 33.9) years, 57 males (54.3%) and 48 females (45.7%). All patients fulfilled the CIBD diagnostic criteria.

Results: About 50% of patients were diagnosed by rheumatologists. Male to female ratio was 1.18:1, with evident female preponderance in patients diagnosed before 20 years old. The most frequent onset sign was oral aphthae. Ocular, genital, skin, neurologic and joint involvement followed in frequency.

Conclusion: both doctors’ and patients’ awareness of BD is increased in Iraq. Early-onset BD tends to involve females more than males with a significant drop of male-to-female ratio as compared to previously reported in national and other Middle-Eastern studies. The clinical characteristics are comparable to those reported from other countries with higher neurologic involvement as compared to previous national reports.

KEYWORDS:

• Behçet disease
• Clinical features
• Iraq
• Male to female ratio
• Patient awareness
• Epidemiologic features
• Behcet disease

Article Highlights

• Behçet disease is a chronic multisystem disease that is classified among vasculitides or more recently as an inflammatory disease at the crossroad between auto-inflammatory and autoimmune syndromes.

• In comparison with previous regional studies, there is a striking drop of male-to-female ratio of Behçet disease, especially in the early onset cases.

• Non-rheumatologist doctors, and even patients, were found to be aware of Behçet disease.

• Neurologic involvement is higher as compared to previous Iraqi data.

Acknowledgments

We express special thanks to the Rheumatology and Neurology Departments at Marjan Teaching Hospital for their help to complete this study.

Author contributions

Conception and design: A Alkazzaz, WR Ebdan. Analysis and interpretation of data: A Alkazzaz, WR Ebdan, MK Ghoben. Paper drafting: A Alkazzaz, WR Ebdan, MK Ghoben. Critical revision: A Alkazzaz, WR Ebdan, MK Ghoben, ZT Kareem, SJ Al-Harbi. Final approval: A Alkazzaz, WR Ebdan.

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

This paper was not funded.