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Behçet Hastalarında Hastalık Aktivitesinin ASO ve CRP Değerleri İle İlişkisi

Year 2024, Volume: 2 Issue: 2, 3 - 11, 31.08.2024

Abstract

Amaç: Behçet hastalığı multisistemik inflamatuar bir hastalıktır ve etiyolojisi henüz net olarak tanımlanamamıştır. Behçet hastalığı remisyon ve ataklarla seyreden bir hastalık olduğu için, hastalığın şiddetini tam olarak yansıtan spesifik bir belirteç bulunmamaktadır. Bu çalışmadaki amacımız Behçet hastalarında C-reaktif protein (CRP) ve ASO (Antistreptolizin-O) değerleri ile hastalık aktivitesi arasındaki ilişkiyi araştırmaktır.
Materyal ve metot: Çalışmamız retrospektif olarak gerçekleştirilmiştir. Ocak 2023-Ocak 2024 tarihleri arasında dermatoloji kliniğimize başvuran Behçet Hastalarının dosyaları retrospektif olarak taranarak hastaların sosyodemografik özellikleri, ASO ve CRP düzeyleri kaydedilerek hastalık aktivitesi ile ilişkisine bakılmıştır. Behçet hastalığının aktivitesini ölçmek için Behçet Hastalığı Güncel Aktivite Formu (BDCAF) kullanıldı. Çalışma verileri SPSS V20 (Released 2018, IBM, NY, ABD) yazılımında analiz edilmiştir.
Bulgular: Çalışmaya Behçet hastalığı tanısı olan 100 hasta dahil edilmiştir. Hastaların %71’i (n=71) kadındı. Yaş ortalaması kadınlarda 37,9±13,1, erkeklerde 34,5±9,8 idi. Behçet hastalarının %94’ünde oral aft, %70’inde genital ülser, %68’inde papülopüstüler lezyon tespit edildi. Nörolojik, gastrointestinal sistem ve vasküler sistem tutulumları daha az oranda görüldü. Çalışmaya katılan 100 behçet hastasının %4’de (n=4) santral sinir sistemi tutulumu, %1’de gastrointestinal sistem tutulumu, %4’de (n=4) vasküler sistem tutulumu mevcuttu. Göz tutulumu ise erkek hastaların 5’de, kadın hastaların 17’de tespit edildi. Hastaların %40’da (n=40) paterji testi pozitif olarak tespit edildi. Aktif Behçet hastalığı olanların ortalama ASO değerleri 157,65 IU/ml bulunmuş olup inaktif Behçet hastalarının ASO değerlerine göre istatistiksel olarak daha anlamlı idi (p<0,05). Aktif Behçet hastalarında ortalama CRP seviyeleri 4,39 mg/L olarak tespit edildi. İnaktif Behçet hastalarının ortalama CRP seviyelerine göre istatistiksel olarak daha yüksekti. Hastaların ASO değerleri ile yaş arasında istatistiksel olarak anlamlı bir fark bulunmazken,
CRP değerleri ile yaş arasındaki ilişki istatistiksel olarak anlamlıydı (p<0,05).
Sonuçlar: Çalışmamızda Behçet hastalarında ASO ve CRP değerleri ile hastalık aktivitesi arasında istatistiksel olarak anlamlı bir ilişki olduğu saptanmıştır. Behçet hastalarının hem hastalık aktivitesini takip etmede hem de olası bir tetikleyici faktör olarak bir enfeksiyon varlığının belirlenmesi için serum ASO ve CRP değerlerinin rutin kontrollerde bakılması gerektiğini düşünmekteyiz.

References

  • Alpsoy E, Leccese P, Ergun T. Editorial: Behçet's disease: epidemiology, etiopathogenesis, diagnosis and treatment. Front Med (Lausanne) 2021;8:794874.
  • Bergamo S, di Meo N, Stinco G, Bonin S, Trevisini S, Trevisan G. Adamantiades-Behçet disease at the beginning of the silk route: north-east Italian experience. Acta Dermatovenerol Croat 2017; 25 (4): 295-7.
  • Behçet H. Uber rezidivierende aphthose, durch ein virus verursachte geschwure, am mund, am auge, und an den genitalien. Dermatol Wochenschr 1937; 105: 1152–7. Kireçtepe Aydın AK, Hatemi G. Heat shock proteins in Behçet syndrome. Balkan Med J 2023;40(5):314-23.
  • Salmaninejad A, Zamani MR, Shabgah AG, Hosseini S, Mollaei F, Hosseini N, et al. Behçet's disease: An immunogenetic perspective. J Cell Physiol 2019; 234(6): 8055-74.
  • Li L, Yu X, Liu J, Wang Z, Li C, Shi J, et.al. Neutrophil extracellular traps promote aberrant macrophages activation in Behçet's disease. Front Immunol 2021 Feb 5;11:590622.
  • Cheng L, Zhan H, Liu Y, Chen H, Zhang F, Zheng W, et.al. Infectious agents and pathogenesis of Behçet's disease: an extensive review. Clin Immunol 2023 Jun; 251: 109631.
  • Hou CC, Guan JL. Risk factors of disease activity in patients with Behçet's syndrome. Clin Rheumatol 2021;40(4):1465-71.
  • Hatemi G, Seyahi E, Fresko I, Talarico R, Hamuryudan V. One year in review 2020: Behçet's syndrome. Clin Exp Rheumatol 2020;38 Suppl 127(5):3-10.
  • Leccese P, Alpsoy E. Behçet's disease: an overview of etiopathogenesis. Front Immunol 2019; 10:1067.
  • Cheng L, Li L, Liu C, Yan S, Chen H, Li H, et al. Variation of red blood cell parameters in Behcet's disease: association with disease severity and vascular involvement. Clin Rheumatol 2021; 40(4): 1457-64.
  • Maness DL, Martin M, Mitchell G. Poststreptococcal illness: recognition and management. Am Fam Physician 2018; 97 (8): 517-22.
  • Kireçtepe Aydın AK, Hatemi G. Heat shock proteins in Behçet syndrome. Balkan Med J 2023;40(5):314-23.
  • Oh SH, Lee KY, Lee JH, Bang D. Clinical manifestations associated with high titer of anti-streptolysin O in Behcet's disease. Clin Rheumatol 2008; 27(8): 999-1003.
  • Emmi G, Prisco D. Behçet's syndrome: focus on pathogenetic background, clinical phenotypes and specific treatments. Intern Emerg Med 2019;14(5):639-43.
  • Uzkeser H, Karatay S, Yildirim K, Karakuzu A, Uyanik MH. Antistreptolysin O levels in patients with Behcet's disease. Eurasian J Med 2011; 43(3): 169-72.

The Relationship Between Disease Activity And ASO And CRP Levels In Behçet’s Disease

Year 2024, Volume: 2 Issue: 2, 3 - 11, 31.08.2024

Abstract

Objective: Behçet’s disease (BD) is a complex inflammatory condition affecting multiple systems, with an unclear etiology. Since BD is characterised by remissions and attacks, there is no specific marker that accurately reflects the severity of the disease. The objective of this study was to examine the correlation between C-reactive protein (CRP) and antistreptolysin-O (ASO) levels and disease activity in BD patients.
Materials and methods: Our study was retrospective. The files of patients with BD who were admitted to our dermatology clinic between January 2023 and January 2024 were retrospectively analyzed. Socio-demographic characteristics, CRP and ASO levels were recorded and the relationship with disease activity was analyzed. Behçet’s Disease Current Activity Form (BDCAF) was used to assess Behçet’s disease activity. The study data were analyzed using SPSS V20 (Released 2018, IBM, NY, USA) software.
Results: The study included 100 patients with BD. 71% (n=71) of the patients were female. The mean age was 37.9±13.1 years for females and 34.5±9.8 years for males. Oral aphthae were found in 94%, genital ulcers in 70%, and papulopustular lesions in 68% of patients with BD. Neurological, gastrointestinal and vascular involvement were less common. Of the 100 patients with Behçet’s disease, 4% (n=4) had central nervous system involvement, 1% had gastrointestinal system involvement and 4% (n=4) had vascular system involvement. Eye involvement was detected in 5 male patients and 17 female patients. The Pathergy test was positive in 40% (n=40) of the patients. The mean ASO value of patients with active Behçet’s disease were 157.65 IU/ml, which was statistically more significant than the ASO values of patients with inactive Behçet’s disease (p<0.05). Mean CRP levels in patients with active Behçet’s disease were 4.39 mg/L. It was statistically higher than the mean CRP levels of inactive Behçet’s patients. ASO and CRP levels were statistically significantly correlated with disease activity (p<0.05). No statistically significant difference was found between ASO levels and age, whereas the relationship between CRP levels and age was statistically significant (p<0.05).
Conclusions: Our study demonstrated a statistically significant correlation between ASO and CRP levels and BD activity. We suggest that serum ASO and CRP levels should be routinely checked in patients with BD to assess disease activity and to identify the presence of infection as a potential triggering factor.

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References

  • Alpsoy E, Leccese P, Ergun T. Editorial: Behçet's disease: epidemiology, etiopathogenesis, diagnosis and treatment. Front Med (Lausanne) 2021;8:794874.
  • Bergamo S, di Meo N, Stinco G, Bonin S, Trevisini S, Trevisan G. Adamantiades-Behçet disease at the beginning of the silk route: north-east Italian experience. Acta Dermatovenerol Croat 2017; 25 (4): 295-7.
  • Behçet H. Uber rezidivierende aphthose, durch ein virus verursachte geschwure, am mund, am auge, und an den genitalien. Dermatol Wochenschr 1937; 105: 1152–7. Kireçtepe Aydın AK, Hatemi G. Heat shock proteins in Behçet syndrome. Balkan Med J 2023;40(5):314-23.
  • Salmaninejad A, Zamani MR, Shabgah AG, Hosseini S, Mollaei F, Hosseini N, et al. Behçet's disease: An immunogenetic perspective. J Cell Physiol 2019; 234(6): 8055-74.
  • Li L, Yu X, Liu J, Wang Z, Li C, Shi J, et.al. Neutrophil extracellular traps promote aberrant macrophages activation in Behçet's disease. Front Immunol 2021 Feb 5;11:590622.
  • Cheng L, Zhan H, Liu Y, Chen H, Zhang F, Zheng W, et.al. Infectious agents and pathogenesis of Behçet's disease: an extensive review. Clin Immunol 2023 Jun; 251: 109631.
  • Hou CC, Guan JL. Risk factors of disease activity in patients with Behçet's syndrome. Clin Rheumatol 2021;40(4):1465-71.
  • Hatemi G, Seyahi E, Fresko I, Talarico R, Hamuryudan V. One year in review 2020: Behçet's syndrome. Clin Exp Rheumatol 2020;38 Suppl 127(5):3-10.
  • Leccese P, Alpsoy E. Behçet's disease: an overview of etiopathogenesis. Front Immunol 2019; 10:1067.
  • Cheng L, Li L, Liu C, Yan S, Chen H, Li H, et al. Variation of red blood cell parameters in Behcet's disease: association with disease severity and vascular involvement. Clin Rheumatol 2021; 40(4): 1457-64.
  • Maness DL, Martin M, Mitchell G. Poststreptococcal illness: recognition and management. Am Fam Physician 2018; 97 (8): 517-22.
  • Kireçtepe Aydın AK, Hatemi G. Heat shock proteins in Behçet syndrome. Balkan Med J 2023;40(5):314-23.
  • Oh SH, Lee KY, Lee JH, Bang D. Clinical manifestations associated with high titer of anti-streptolysin O in Behcet's disease. Clin Rheumatol 2008; 27(8): 999-1003.
  • Emmi G, Prisco D. Behçet's syndrome: focus on pathogenetic background, clinical phenotypes and specific treatments. Intern Emerg Med 2019;14(5):639-43.
  • Uzkeser H, Karatay S, Yildirim K, Karakuzu A, Uyanik MH. Antistreptolysin O levels in patients with Behcet's disease. Eurasian J Med 2011; 43(3): 169-72.
There are 15 citations in total.

Details

Primary Language English
Subjects Dermatology
Journal Section Research Article
Authors

Erdal Pala 0000-0001-7362-4891

Ceren Çimen 0009-0002-8223-9113

Publication Date August 31, 2024
Submission Date June 20, 2024
Acceptance Date August 20, 2024
Published in Issue Year 2024 Volume: 2 Issue: 2

Cite

Vancouver Pala E, Çimen C. The Relationship Between Disease Activity And ASO And CRP Levels In Behçet’s Disease. SMJ. 2024;2(2):3-11.