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Ocular involvement in Adamantiades-Behçet’s disease in Berlin, Germany

  • Lothar Krause
  • Anne-Katrin Köhler
  • Andreas Altenburg
  • Nestor Papoutsis
  • Christos C. Zouboulis
  • Uwe Pleyer
  • Andrea Stroux
  • Michael H. Foerster
Inflammatory Disorders

Abstract

Background

Epidemiological studies demonstrate a prevalence of Adamantiades-Behçet’s disease (ABD) in the range of 0.12–420 per 100,000 inhabitants, with the highest rates in Istanbul, Turkey, and the lowest rates in the USA. Ophthalmological data on the prevalence of ocular involvement are limited for ABD in Germany, because most epidemiological studies are based on rheumatological or dermatological data. Berlin is the city with the highest number of non-native German inhabitants, and its multi-ethnic character renders it uniquely appropriate for epidemiological studies on ABD.

Methods

We retrospectively analyzed all ABD patients seen in our department since 1982. All patients fulfilled the criteria of the International Study Group for Behçet’s Disease. We found 140 patients (63 female, 77 male), with a mean follow-up of 6.4 years (0.5–22 years).

Results

The mean age was 23 at the first manifestation and 32 when the full-blown disease was noted. The mean age at onset of ocular involvement was 30. Most of the patients were of Turkish (n = 73) or German (n = 34) origin. Fifty-six percent developed ocular involvement, which was the first manifestation in 8.6% and the second manifestation in 19.3% of cases.

Conclusions

More than half the patients developed ocular involvement. The calculated prevalence of ocular involvement in ABD is 1.77/100,000 inhabitants for the municipality of Berlin.

Keywords

Adamantiades-Behçet’s disease Prevalence Epidemiology 

Notes

Acknowledgement

The authors would like to thank Dr. Joanne Weirowski for her editorial contribution.

References

  1. 1.
    Zouboulis CC, May T (2003) Pathogenesis of Adamantiades-Behcet’s disease. Med Microbiol Immunol 192:149–155 doi: 10.1007/s00430-002-0167-5 PubMedCrossRefGoogle Scholar
  2. 2.
    Kotter I, Vonthein R, Muller CA, Gunaydin I, Zierhut M, Stubiger N (2004) Behcet’s disease in patients of German and Turkish origin living in Germany: a comparative analysis. J Rheumatol 31:133–139PubMedGoogle Scholar
  3. 3.
    Krause L (2005) Adamantiades-Behcet’s disease. Ophthalmologe 102:329–334 doi: 10.1007/s00347-004-1166-2 PubMedCrossRefGoogle Scholar
  4. 4.
    Zouboulis CC (1999) Epidemiology of Adamantiades-Behcet’s disease. Ann Med Interne (Paris) 150:488–498Google Scholar
  5. 5.
    Papoutsis NG, Abdel-Naser MB, Altenburg A et al (2006) Prevalence of Adamantiades-Behçet’s disease in Germany and the municipality of Berlin: Results of a nationwide survey. Clin Exp Rheumatol 24(suppl 42):S125, Erratum in Clin Exp Rheumatol (2007) 25:507–508PubMedGoogle Scholar
  6. 6.
    Altenburg A, Papoutsis N, Orawa H, Martus P, Krause L, Zouboulis CC (2006) Epidemiology and clinical manifestations of Adamantiades-Behcet disease in Germany - current pathogenetic concepts and therapeutic possibilities. J Dtsch Dermatol Ges 4:49–64, quiz 65–66 doi: 10.1111/j.1610-0387.2006.05841.x PubMedGoogle Scholar
  7. 7.
    International Study Group for Behcet’s Disease (1990) Criteria for diagnosis of Behcet’s disease. Lancet 335:1078–1080Google Scholar
  8. 8.
    Azizlerli G, Kose AA, Sarica R et al (2003) Prevalence of Behcet’s disease in Istanbul, Turkey. Int J Dermatol 42:803–806 doi: 10.1046/j.1365-4362.2003.01893.x PubMedCrossRefGoogle Scholar
  9. 9.
    Mishima S, Masuda K, Izawa Y, Mochizuki M, Namba K (1979) The eighth Frederick H. Verhoeff Lecture. presented by Saiichi Mishima, MD Behcet’s disease in Japan: ophthalmologic aspects. Trans Am Ophthalmol Soc 77:225–279PubMedGoogle Scholar
  10. 10.
    Ando K, Fujino Y, Hijikata K, Izawa Y, Masuda K (1999) Epidemiological features and visual prognosis of Behcet’s disease. Jpn J Ophthalmol 43:312–317 doi: 10.1016/S0021-5155(99)00029-5 PubMedCrossRefGoogle Scholar
  11. 11.
    Hamdan A, Mansour W, Uthman I, Masri AF, Nasr F, Arayssi T (2006) Behcet’s disease in Lebanon: clinical profile, severity and two-decade comparison. Clin Rheumatol 25:364–367 doi: 10.1007/s10067-005-0058-4 PubMedCrossRefGoogle Scholar
  12. 12.
    Shahram F, Davatchi F, Nadji A et al (2003) Recent epidemiological data on Behcet’s disease in Iran. The 2001 survey. Adv Exp Med Biol 528:31–36 doi: 10.1007/0-306-48382-3_5 PubMedCrossRefGoogle Scholar
  13. 13.
    Yoshida A, Kawashima H, Motoyama Y et al (2004) Comparison of patients with Behcet’s disease in the 1980s and 1990s. Ophthalmology 111:810–815 doi: 10.1016/j.ophtha.2003.07.018 PubMedCrossRefGoogle Scholar
  14. 14.
    Zierhut M, Saal J, Pleyer U, Kotter I, Durk H, Fierlbeck G (1995) Behcet’s disease: epidemiology and eye manifestations in German and Mediterranean patients. Ger J Ophthalmol 4:246–251PubMedGoogle Scholar
  15. 15.
    Elgin U, Berker N, Batman A (2004) Incidence of secondary glaucoma in behcet disease. J Glaucoma 13:441–444 doi: 10.1097/00061198-200412000-00002 PubMedCrossRefGoogle Scholar
  16. 16.
    Tugal-Tutkun I, Onal S, Altan-Yaycioglu R, Huseyin Altunbas H, Urgancioglu M (2004) Uveitis in Behcet disease: an analysis of 880 patients. Am J Ophthalmol 138:373–380 doi: 10.1016/j.ajo.2004.03.022 PubMedCrossRefGoogle Scholar
  17. 17.
    Ozdal PC, Ortac S, Taskintuna I, Firat E (2002) Posterior segment involvement in ocular Behcet’s disease. Eur J Ophthalmol 12:424–431PubMedGoogle Scholar
  18. 18.
    Krist D, Schönherr U, Wenkel H (2000) Adamantiadis-Behcet syndrome: fluorescein angiography and choroid ischemia. Klin Monatsbl Augenheilkd 216:45–50 doi: 10.1055/s-2000-10515 PubMedCrossRefGoogle Scholar
  19. 19.
    Benezra D, Cohen E (1986) Treatment and visual prognosis in Behcet’s disease. Br J Ophthalmol 70:589–592 doi: 10.1136/bjo.70.8.589 PubMedCrossRefGoogle Scholar
  20. 20.
    Gurler A, Boyvat A, Tursen U (1997) Clinical manifestations of Behcet’s disease: an analysis of 2147 patients. Yonsei Med J 38:423–427PubMedGoogle Scholar
  21. 21.
    Ambresin A, Tran T, Spertini F, Herbort C (2002) Behcet’s disease in Western Switzerland: epidemiology and analysis of ocular involvement. Ocul Immunol Inflamm 10:53–63 doi: 10.1076/ocii.10.1.53.10326 PubMedCrossRefGoogle Scholar
  22. 22.
    Torres RM, Yanez B, Herreras JM, Calonge M (2004) Ocular Behcet disease. Retrospective study. Arch Soc Esp Oftalmol 79:599–603PubMedGoogle Scholar
  23. 23.
    Chung YM, Yeh TS, Sheu MM et al (1990) Behcet’s disease with ocular involvement in Taiwan: a joint survey of six major ophthalmological departments. J Formos Med Assoc 89:413–417PubMedGoogle Scholar
  24. 24.
    Muhaya M, Lightman S, Ikeda E et al (2000) Behcet’s disease in Japan and in Great Britain: a comparative study. Ocul Immunol Inflamm 8:141–148 doi: 10.1076/0927-3948(200009)8:3;1-K;FT141 PubMedCrossRefGoogle Scholar
  25. 25.
    Escudier M, Bagan J, Scully C (2006) Number VII Behcet’s disease (Adamantiades syndrome). Oral Dis 12:78–84 doi: 10.1111/j.1601-0825.2005.01144.x PubMedCrossRefGoogle Scholar
  26. 26.
    Tanaka C, Matsuda T, Hayashi E, Imamura Y, Ozaki S (2003) Clinical manifestations and course of 200 Japanese patients with Behcet’s disease. Adv Exp Med Biol 528:77–79 doi: 10.1007/0-306-48382-3_14 PubMedCrossRefGoogle Scholar
  27. 27.
    Saylan T, Ozarmagan G, Azizlerli G, Ovul C, Oke N (1986) Behcet disease in Turkey. Z Hautkr 61:1120–1122PubMedGoogle Scholar
  28. 28.
    Zouboulis CC, Turnbull JR, Martus P (2003) Univariate and multivariate analyses comparing demographic, genetic, clinical, and serological risk factors for severe Adamantiades-Behçet’s Disease. In: Zouboulis CC (ed) Adamantiades-Behçet’s Disease. Kluwer/Plenum, London Amsterdam, pp 123–126Google Scholar
  29. 29.
    Krause L, Köhler AK, Altenburg A et al (2008) Ocular involvement is associated with HLA-B51 in Adamantiades-Behçet’s disease. Eye (Jun):13. Epub ahead of printGoogle Scholar

Copyright information

© Springer-Verlag 2008

Authors and Affiliations

  • Lothar Krause
    • 1
  • Anne-Katrin Köhler
    • 1
  • Andreas Altenburg
    • 2
  • Nestor Papoutsis
    • 2
  • Christos C. Zouboulis
    • 2
  • Uwe Pleyer
    • 3
  • Andrea Stroux
    • 4
  • Michael H. Foerster
    • 1
  1. 1.Department of OphthalmologyCharité - Campus Benjamin FranklinBerlinGermany
  2. 2.Departments of Dermatology and ImmunologyDessau Medical CenterDessauGermany
  3. 3.Department of Ophthalmology, Campus Virchow-KlinikumCharité Universitaetsmedizin BerlinBerlinGermany
  4. 4.Institute of Medical Informatics, Biometry and Epidemiology, Campus Benjamin FranklinCharité Universitaetsmedizin BerlinBerlinGermany

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