Background/Purpose: Behcet’s syndrome (BS) is a multisystem disease that typically manifests as recurrent oral and genital ulcers, along with skin, eye, gastrointestinal, neurologic and vascular involvement. BS is believed to be prevalent among Muslims and Druze in Israel. Since the studies by Krause more than 15 years ago, very few studies describing the characteristics of BS among Israeli patients have been published.The aim of this study is to describe the baseline characteristics of our patients with BS, and compare demographic and clinical features between Jewish and Arab subpopulations.

Methods: We retrospectively reviewed our BS cohort and identified patients with active follow up. Electronic medical records were reviewed, and demographic, clinical, laboratory and medications’ prescription data were extracted for each patient. Further, we compared the Jewish and Arabic subpopulations with regard to demographic and clinical features.  

Results: Our cohort included 98 patients. Males constituted 49 (50%) of the cohort, mean age at the time of diagnosis was 29.9 years old (range of 6-64). Seventy one (72.4%) Arab (45 (45.9%) Muslims, 21 (27.6%) Druze and 5 (5.1%) Christians). Oral and genital ulcers were evident in 93 (94.9%) and 54 (55.1%) patients, respectively. Involvement of the skin, joints, eye, GI tract, neurologic and vascular systems were demonstrated among 42 (42.9%), 57 (58.2%), 47 (48.0%), 8 (8.2%), 10 (10.2%), 15 (15.3%), respectively. Five (5.1%) had cardiac involvement, one patient had pulmonary hemorrhage and 2 patients had orcho-epididymitis. HLA B51 was performed in 37 (37.8%) patients and was positive in 24 (64.9%). Pathergy test was performed in 12 (12.2%) patients and was positive in 8 (66.7%). Psoriasis and FMF were evident in one patient each. Colchicine was used in 82 (83.7%) cases, azathioprine 47 (48%), methotrexate 16 (16.3%), apremilast 10 (10.2%), cyclosporine-A 8 (8.2%), adalimumab 26 (26.5%), infliximab 12 (12.2%), cyclophosphamide 1 (1.0%), tocilizumab 2 (2.0%) and anti-coagulation 6 (6.1%). The Arab and Jewish subpopulations were significantly different with regard to male (or female) proportion, 40 (56.3%) vs 9 (33.3%), p=0.042.

Conclusion: BS is more common among Arabs compared to Jews in northern Israel, especially among Druze and Muslims, but no significant clinical or demographic differences were found except for higher proportion of male patients among Arabs. Further studies are warranted to understand the true prevalence and genetic bases among the Arab, especially Druze, subpopulation.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/the-characteristics-of-a-northern-israeli-cohort-of-patients-with-behcets-syndrome/