ACR Meeting Abstracts

ACR Meeting Abstracts

Abstract Number: 1150

Ocular Involvement Is Exclusive with Genital Ulcer and Skin Lesion in the Early Phase of Behçet’s Disease: Nationwide Japanese Registration.

Nobuyuki Horita1, Akiko Suwa2, Mitsuhiro Takeno3, Takehito Ishido2, Yohei Kirino4 and Nobuhisa Mizuki5, 1National Human Genome Research Institute, National Institutes of Health, Bethesda, MD, 2Department of Ophthalmology and Visual Science, Yokohama City University Graduate School of Medicine, Yokohama, Japan, 3Department of Allergy and Rheumatology, Nippon Medical School Graduate School of Medicine, Tokyo, Japan, 4Department of Stem Cell and Immune Regulation, Yokohama City University Graduate School of Medicine, Yokohama, Japan, 5Yokohama City University, Yokohama, Japan

Meeting: 2017 ACR/ARHP Annual Meeting

Date of first publication: September 18, 2017

Keywords: ,

Session Information

Date: Monday, November 6, 2017

Title: Miscellaneous Rheumatic and Inflammatory Diseases Poster I

Session Type: ACR Poster Session B

Session Time: 9:00AM-11:00AM

Background/Purpose: Behçetfs disease (BD) is a chronic inflammatory syndrome with features of multi-organ involvement and presents with mucocutaneous and ocular symptoms. We have previously found that eye involvement was significantly associated with neurologic lesions, while the coexistence with intestinal involvement was uncommon. Moreover, a couple of studies have revealed some phenotypical clustering among the patients with BD. This study aimed to identify the high-risk patients for ocular involvement

Methods: The Japanese Ministry of Health, Labour and Welfare provided the dataset of ongoing nationwide BD registration project. We analyzed newly registered patients who fulfilled the International Study Group (ISG) criteria. To have an overview on the associations between manifestations, we made Yulefs Q matrix. After this screening process, we estimated how each risk factor associated with ocular lesions using odds ratio (OR). We also conducted a logistic regression analysis, wherein the ocular lesion was a dependent variable.

Results: Among 2399 eligible BD patients, 941 (39%) were men and 1458 (61%) were women with a median age of 37 years (interquartile range (IQR) 29-44 years) (Abstract Table 1). The median duration between onset and registration was 0 year (IQR 0-3). Genital ulceration and skin lesions had Yulefs Q values of -0.82 and -0.75, respectively. These values indicated that the absence of genital ulceration and skin lesions were risk factor of ocular involvement. Among 1915 patients with genital ulceration, 383 (20%) had ocular lesions, while among 484 patients without genital ulceration, 348 (72%) had ocular lesions (Abstract Table 2). This yielded an OR of 0.10 (95%CI 0.08-0.12, P < 0.001). Among 2308 patients with skin lesions, 664 (29%) had ocular lesions, while among 91 patients without genital ulceration, 67 (74%) had ocular lesions, yielding an OR of 0.15 (95%CI 0.09-0.23, P < 0.001). Subgroup analyses constantly replicated these results (Abstract Table 2). The logistic regression analysis identified skin lesion (OR 0.08, 95%CI 0.05-0.13, P < 0.001) and genital ulceration (OR 0.08, 95%CI 0.06-0.10, P < 0.001) as protective factors or ocular lesions (Abstract Table 3).

Conclusion: The absence of genital ulceration and skin lesions were risk factor of ocular involvement of BD.

T1

 

All analyzable cases

International Study Group criteria

Number of patients

3213

2399

Age year, median

38 (IQR 30-49)

37 (IQR 29-47)

Men

1382 (43%)

941 (39%)

Women

1831 (57%)

1458 (61%)

Oral ulceration

3044 (95%)

2399 (100%)

Onset registration duration (year)

1 (IQR 0-3)

0 (IQR 0-3)

  0 year

1593 (50%)

1222 (51%)

  1-9 years

1237 (39%)

893 (37%)

  10- years

383 (12%)

284 (12%)

Skin lesion

2673 (83%)

2308 (96%)

Ocular lesion

891 (28%)

731 (31%)

Genital ulceration

2101 (65%)

1915 (80%)

Positive pathergy test

1016 (32%)

975 (41%)

Arthritis

1620 (50%)

1290 (54%)

Epididymitis (male only)

126/1382 (9%)

94/941 (10%)

Gastrointestinal symptom

998 (31%)

633 (26%)

Vascular lesion

368 (12%)

255 (11%)

Neurological manifestation

692 (22%)

493 (21%)

Iridcyclitis

637 (20%)

523 (22%)

Retino-uveitis

596 (19%)

480 (20%)

T2

Patient background

Ocular lesion

Genital ulcer

Skin lesion

(+)

(-)

OR (95%CI), P

(+)

(-)

OR (95%CI), P

All cases

(N = 2399)

Ocular lesion (+)

Ocular lesion (-)

383

1532

348

136

0.10 (0.08-0.12)

P < 0.001

664

1644

67

24

0.15 (0.09-0.23)

P < 0.001

Male

(N = 941)

Ocular lesion (+)

Ocular lesion (-)

169

469

229

74

0.12 (0.08-0.16)

P < 0.001

371

535

27

8

0.21 (0.09-0.46)

P < 0.001

Female

(N = 1459)

Ocular lesion (+)

Ocular lesion (-)

214

1063

119

62

0.11 (0.08-0.15)

P < 0.001

293

1109

40

16

0.11 (0.06-0.19)

P < 0.001

Age < median, -36 years

(N = 1145)

Ocular lesion (+)

Ocular lesion (-)

163

776

144

62

0.09 (0.06-0.13)

P < 0.001

278

828

29

10

0.12 (0.06-0.24)

P < 0.001

Age > median, 37- years

(N = 1254)

Ocular lesion (+)

Ocular lesion (-)

220

756

204

74

0.11 (0.08-0.14)

P < 0.001

386

816

38

14

0.17 (0.09-0.33)

P < 0.001

Onset-, 0 y

(N = 1222)

Ocular lesion (+)

Ocular lesion (-)

170

818

159

75

0.10 (0.07-0.14)
P < 0.001

294

880

35

13

0.12 (0.07-0.24)

P < 0.001

Onset-, 1-9 years

(N = 893)

Ocular lesion (+)

Ocular lesion (-)

126

566

157

44

0.06 (0.04-0.09)

P < 0.001

260

603

23

7

0.13 (0.03-0.30)

P < 0.001

Onset-, 10- years

(N = 284)

Ocular lesion (+)

Ocular lesion (-)

87

148

32

17

0.31 (0.16-0.58)

P < 0.001

110

161

9

4

0.30 (0.10-0.99)

P = 0.048

All cases

(N = 2399)

Iridocyclitits (+)

Iridocyclitits (-)

262

1653

261

223

0.14 (0.11-0.17)

P < 0.001

475

1833

48

43

0.23 (0.15-0.36)

P < 0.001

All cases

(N = 2399)

Retino-uveitis (+)

Retino-uveitis (-)

239

1676

241

243

0.14 (0.11-0.18)

P < 0.001

432

1876

48

43

0.21 (0.14-0.32)

P < 0.001

T3

N = 2399

OR (95%CI)

P

Age (10 years)

1.12 (1.04-1.21)

0.004

Female

0.55 (0.44-0.68)

< 0.001

Skin lesion

0.08 (0.05-0.13)

< 0.001

Genital ulceration

0.08 (0.06-0.10)

< 0.001

Positive pathergy test

0.51 (0.40-0.64)

< 0.001

Arthritis

0.91 (0.74-1.13)

0.397

Gastrointestinal symptom

0.50 (0.39-0.65)

< 0.001

Vascular lesion

0.98 (0.70-1.37)

0.898

Neurological manifestation

1.12 (0.86-1.45)

0.394

 

Disclosure: N. Horita, None; A. Suwa, None; M. Takeno, None; T. Ishido, None; Y. Kirino, None; N. Mizuki, None.

To cite this abstract in AMA style:

Horita N, Suwa A, Takeno M, Ishido T, Kirino Y, Mizuki N. Ocular Involvement Is Exclusive with Genital Ulcer and Skin Lesion in the Early Phase of Behçet’s Disease: Nationwide Japanese Registration. [abstract]. Arthritis Rheumatol. 2017; 69 (suppl 10). https://acrabstracts.org/abstract/ocular-involvement-is-exclusive-with-genital-ulcer-and-skin-lesion-in-the-early-phase-of-behcets-disease-nationwide-japanese-registration/. Accessed .

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