Abstract
To evaluate the prevalence of Behçet’s disease (BD) in a Druze community in Israel, we conducted a two-stage clinic-based survey in an Israeli Druze town. The first stage aimed to identify patients with recurrent aphthous stomatitis (RAS) in all patients who visited three of the largest clinics in the town during a period of 6 months. The second stage aimed to identify those patients with RAS who fulfilled the diagnostic criteria for BD according to the International Study Group (ISG) criteria. One thousand and eighty-three out of about 4,000 registered subjects were interviewed, 63 of whom had RAS (5.8%). Two patients fulfilled the ISG criteria for BD, resulting in a calculated prevalence in the range of 2:1,083–2:4,000, i.e., 50–185:100,000. Another two patients with oral and genital aphthosis but without eye or skin lesions were diagnosed as suspected BD. The very high prevalence of BD, as found in our study, places the Druze among the populations with the highest prevalence of the disease all over the world, though selection biases could account for overestimation as well as underestimation of the actual BD prevalence. Our findings call for genetic studies to explore whether there is a genetic predisposition to BD in this population.
References
Kaklamani VG, Vaiopoulos G, Kaklamanis PG (1998) Behcet's disease. Semin Arthritis Rheum 27:197–217
Yazici H, Yurdakul S, Hamuryudan V (1999) Behcet's syndrome. Curr Opin Rheumatol 11:53–57
Sakane T, Takeno M, Suzuki N, Inaba G (1999) Behcet's disease. N Engl J Med 341:1284–1291
Azizlerli G, Kose AA, Sarica R, Gul A, Tutkun IT, Kulac M et al (2003) Prevalence of Behcet's disease in Istanbul, Turkey. Int J Dermatol 42:803–806
Cakir N, Dervis E, Benian O, Pamuk ON, Sonmezates N, Rahimoglu R et al (2004) Prevalence of Behcet's disease in rural western Turkey: a preliminary report. Clin Exp Rheumatol 22:S53–S55
Calamia KT, Wilson FC, Icen M, Crowson CS, Gabriel SE, Kremers HM (2009) Epidemiology and clinical characteristics of Behcet's disease in the US: a population-based study. Arthritis Rheum 61:600–604
Davatchi F, Jamshidi AR, Banihashemi AT, Gholami J, Forouzanfar MH, Moradi M et al (2007) Prevalence of Behcet's disease in Iran: a WHO-ILAR COPCORD stage I study APLAR. J Rheumatol 10:239–243
Idil A, Gurler A, Boyvat A, Caliskan D, Ozdemir O, Isik A et al (2002) The prevalence of Behcet's disease above the age of 10 years. The results of a pilot study conducted at the Park Primary Health Care Center in Ankara, Turkey. Ophthalmic Epidemiol 9:325–331
Jaber L, Milo G, Halpern GJ, Krause I, Weinberger A (2002) Prevalence of Behcet's disease in an Arab community in Israel. Ann Rheum Dis 61:365–366
Krause I, Yankevich A, Fraser A, Rosner I, Mader R, Zisman D et al (2007) Prevalence and clinical aspects of Behcet's disease in the north of Israel. Clin Rheumatol 26:555–560
Mahr A, Belarbi L, Wechsler B, Jeanneret D, Dhote R, Fain O et al (2008) Population-based prevalence study of Behcet's disease: differences by ethnic origin and low variation by age at immigration. Arthritis Rheum 58:3951–3959
Papoutsis NG, Abdel-Naser MB, Altenburg A, Orawa H, Kotter I, Krause L et al (2006) Prevalence of Adamantiades-Behcet's disease in Germany and the municipality of Berlin: results of a nationwide survey. Clin Exp Rheumatol 24:S125
Salvarani C, Pipitone N, Catanoso MG, Cimino L, Tumiati B, Macchioni P et al (2007) Epidemiology and clinical course of Behcet's disease in the Reggio Emilia area of Northern Italy: a seventeen-year population-based study. Arthritis Rheum 57:171–178
Tunes RS, Anjos TC, Martins GB, Barreto ER, Santiago MB (2009) Prevalence of Behcet's syndrome in patients with recurrent aphthous ulcerations in Brazil. Rheumatol Int 29:875–878
Yurdakul S, Gunaydin I, Tuzun Y, Tankurt N, Pazarli H, Ozyazgan Y et al (1988) The prevalence of Behcet's syndrome in a rural area in northern Turkey. J Rheumatol 15:820–822
Zouboulis CC (1999) Epidemiology of Adamantiades-Behcet's disease. Ann Med Interne (Paris) 150:488–498
Zouboulis CC, Kotter I, Djawari D, Kirch W, Kohl PK, Ochsendorf FR et al (1997) Epidemiological features of Adamantiades-Behcet's disease in Germany and in Europe. Yonsei Med J 38:411–422
Al-Dalaan A, AlBallaa S, AlSukait M, Mousa M, Bahabri SA, Biyari T (1997) The prevalence of Behcet's disease in Al Qassim region of Saudi Arabia. In: Hamza M (ed) Behcet's disease. Pub Adhouva, Tunisia, pp 170–172
Assaad-Khalil SH, Kamel FA, Ismai EA (1997) Starting a regional registry for patients with Behçet's disease in North West Nile Delta region in Egypt. In: Hamza M (ed) Behcet's disease. Pub Adhouva, Tunisia, pp 173–176
Shahram F, Davatchi F, Akbarian M, Gharibdoost F, Nadji A, Jamshidi AR (1997) The 1996 survey of Behcet's disease in Iran, study of 3153 cases. In: Hamza M (ed) Behcet's disease. Pub Adhoua, Tunis, pp 165–169
Davatchi F (1998) Epidemiology of Behçet's disease in Middle East and Asia, in 8th International Congress on Behçet's Disease. In: Olivieri I, Salvarani C, Cantini F (eds) Program and abstracts. Prex, Milano, p 42
Nakae K, Masaki F, Hashimoto T, Inaba G, Mochizuki M, Sakane T (1993) Recent epidemiological features of Behcet's disease in Japan. In: Wechsler B, Godeau P (eds) Behcet's disease. International congress series. Excerpta Medica, Amsterdam, pp 145–151
Chamberlain MA (1979) Epidemiological features of Behçet's syndrome. In: Lehner F, Barnes CG (eds) Behçet's syndrome. Clinical and immunologic features. Proceedings of a conference sponsored by the Royal Society of Medicine. Academic, London, pp 213–222
O'Duffy JD (1980) Summary of an international symposium on Behçet's disease. J Rheumatol 5:229–233
International Study Group for Behcet's Disease (1990) Criteria for diagnosis of Behcet's disease. Lancet 335:1078–1080
Krause I, Mader R, Sulkes J, Paul M, Uziel Y, Adawi M et al (2001) Behcet's disease in Israel: the influence of ethnic origin on disease expression and severity. J Rheumatol 28:1033–1036
Krause I, Rosen Y, Kaplan I, Milo G, Guedj D, Molad Y et al (1999) Recurrent aphthous stomatitis in Behcet's disease: clinical features and correlation with systemic disease expression and severity. J Oral Pathol Med 28:193–196
Chung YM, Yeh TS, Sheu MM, Chen MS, Wen MS, Tsai HY et al (1990) Behcet's disease with ocular involvement in Taiwan: a joint survey of six major ophthalmological departments. J Formos Med Assoc 89:413–417
Davatchi F, Shahram F, Chams C, Chams H, Akbarian M, Gharibdoost F et al (2000) Epidemiology of Behcet's disease in Iran. In: Bang D, Lee ES, Lee S (eds) Behcet's disease. Seoul
Mousa AR, Marafie AA, Rifai KM, Dajani AI, Mukhtar MM (1986) Behcet's disease in Kuwait, Arabia. A report of 29 cases and a review. Scand J Rheumatol 15:310–332
Shlush LI, Behar DM, Yudkovsky G, Templeton A, Hadid Y, Basis F et al (2008) The Druze: a population genetic refugium of the Near East. PLoS ONE 3:e2105
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Klein, P., Weinberger, A., Altmann, V.J. et al. Prevalence of Behcet’s disease among adult patients consulting three major clinics in a Druze town in Israel. Clin Rheumatol 29, 1163–1166 (2010). https://doi.org/10.1007/s10067-010-1472-9
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DOI: https://doi.org/10.1007/s10067-010-1472-9