Disease Assessment in Behçet’s Disease

  • Gonca Mumcu
  • Yusuf Yazıcı
  • M. Anne Chamberlain
Chapter
First Online:

Abstract

Behçet’s disease (BD) starts early and may last a long time so that the whole of the working life and the family can be compromised by the disease process. A few disease assessment measures have been studied in BD. The ones that have been developed specifically for BD are small in number, and most lack coverage for some manifestations of the disease, which may be seen with different frequencies in different parts of the world, such as gastrointestinal and neurological involvement. Eye involvement, the main cause of morbidity, still lacks good and easy to use assessment tools. Part of the reason for lack of disease assessment measures in Behçet’s disease may be that methodology of disease assessment tool development has to be valid, and this is not widely appreciated.

Keywords

Behçet’s disease Disease activity Indices Measurement Oral health Quality of life 
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References

  1. 1.
    Sut N, Seyahi E, Yurdakul S, Senocak M, Yazici H (2007) A cost analysis of Behçet’s syndrome in Turkey. Rheumatology (Oxford) 46:678–682CrossRefGoogle Scholar
  2. 2.
    Prevoo ML, Van’t Hof MA, Kuper HH, van Leeuwen MA, van de Putte LB, van Riel PL (1995) Modified disease activity scores that include twenty-eight-joint counts. Development and validation in a prospective longitudinal study of patients with rheumatoid arthritis. Arthritis Rheum 38:44–48PubMedCrossRefGoogle Scholar
  3. 3.
    Yazici H, Tuzun Y, Pazarli H, Yurdakul S, Ozyazgan Y, Ozdogan H, Serdaroglu S, Ersanli M, Ulkü BY, Müftüoğlu AU (1984) Influence of age of onset and patient’s sex on the prevalence and severity of manifestations of Behçet’s syndrome. Ann Rheum Dis 43:783–789PubMedCrossRefGoogle Scholar
  4. 4.
    Lawton G, Bhakta BB, Chamberlain MA, Tennant A (2004) The Behçet’s disease activity index. Rheumatology (Oxford) 43:73–78CrossRefGoogle Scholar
  5. 5.
    Beaton DE (2000) Understanding the relevance of measured change through studies of responsiveness. Spine 25:3192–3199PubMedCrossRefGoogle Scholar
  6. 6.
    Lee ES, Kim HS, Bang D, Yu HG, Chung H, Shin DH, Song YW, Park YB, Lee SK, Shin SK, Kim WH, Choi J, Park BJ, Lee S (2003) Development of clinical activity form for Korean patients with Behçet’s disease. Adv Exp Med Biol 528:153–156PubMedCrossRefGoogle Scholar
  7. 7.
    Neves FS, Moraes JC, Kowalski SC, Goldenstein-Schainberg C, Lage LV, Gonçalves CR (2007) Cross-cultural adaptation of the Behçet’s Disease Current Activity Form (BDCAF) to Brazilian Portuguese language. Clin Rheumatol 26:1263–1267PubMedCrossRefGoogle Scholar
  8. 8.
    Hamuryudan V, Fresko I, Direskeneli H, Tenant MJ, Yurdakul S, Akoglu T, Yazici H (1999) Evaluation of the Turkish translation of a disease activity form for Behçet’s syndrome. Rheumatology (Oxford) 38:734–736CrossRefGoogle Scholar
  9. 9.
    Forbess C, Swearingen C, Yazici Y (2008) Behçet’s Syndrome Activity Score (BSAS): a new disease activity assessment tool, composed of patient-derived measures only, is strongly correlated with The Behçet’s Disease Current Activity Form (BDCAF). Ann Rheum Dis 67(SII):360Google Scholar
  10. 10.
    Shahram F, Khabbazi A, Nadji A, Ziaie N, Banihashemi AT, Davatchi F (2009) Comparison of existing disease activity indices in the follow-up of patients with Behçet’s disease. Mod Rheumatol 19(5):536–541PubMedCrossRefGoogle Scholar
  11. 11.
    Simsek I, Meric C, Erdem H, Pay S, Kilic S, Dinc A (2008) Accuracy of recall of the items included in disease activity forms of Behçet’s disease: comparison of retrospective questionnaires with a daily telephone interview. Clin Rheumatol 27:1255–1260PubMedCrossRefGoogle Scholar
  12. 12.
    Bang D, Kim HS, Lee ES, Lee S (2000) The significance of laboratory test in evaluating the clinical activity of Behçet’s disease. In: Proceedings of the 9th international conference in Behçet’s disease held in Seoul, Korea, 27–29 MayGoogle Scholar
  13. 13.
    Deuter CME, Kotter I, Gunaydin I, Zierhut M, Stubiger N (2004) Ocular involvement in Behçet’s disease: first 5-year-results for visual development after treatment with interferon alfa-2a. Ophthalmologe 101:129–134PubMedCrossRefGoogle Scholar
  14. 14.
    Amberger M, Groll S, Günaydin I, Deuter C, Vonthein R, Kötter I (2007) Intracellular cytokine patterns in Behçet’s disease in comparison to ankylosing spondylitis – influence of treatment with interferon-alpha2a. Clin Exp Rheumatol 25(Suppl 45):S52–S57PubMedGoogle Scholar
  15. 15.
    Kötter I, Koch S, Vonthein R, Rückwaldt U, Amberger M, Günaydin I, Zierhut M, Stübiger N (2005) Cytokines, cytokine antagonists and soluble adhesion molecules in patients with ocular Behçet’s disease treated with human recombinant interferon-alpha2a. Results of an open study and review of the literature. Clin Exp Rheumatol 23(Suppl 38):S20–S26PubMedGoogle Scholar
  16. 16.
    Cekmen M, Evereklioglu C, Er H, Inaloz HS, Doganay S, Yurkoz Y, Ozerol IH (2003) Vascular endothelial growth factor levels are increased and associated with disease activity in patients with Behçet’s syndrome. Int J Dermatol 42(11):870–875PubMedCrossRefGoogle Scholar
  17. 17.
    Nanke Y, Kotake S, Goto M, Ujihara H, Matsubara M, Kamatani N (2008) Decreased percentages of regulatory T cells in peripheral blood of patients with Behçet’s disease before ocular attack: a possible predictive marker of ocular attack. Mod Rheumatol 18(4):354–358PubMedCrossRefGoogle Scholar
  18. 18.
    Pay S, Abbasov T, Erdem H, Musabak U, Simsek I, Pekel A, Akdogan A, Sengul A, Dinc A (2007) Serum MMP-2 and MMP-9 in patients with Behçet’s disease: do their higher levels correlate to vasculo-Behçet’s disease associated with aneurysm formation? Clin Exp Rheumatol 25(Suppl 45):S-70–S-75Google Scholar
  19. 19.
    Tugal-Tutkun I, Herbort CP, Khairallah M (2008) The Angiography Scoring for Uveitis Working Group (ASUWOG). Scoring of dual fluorescein and ICG inflammatory angiographic signs for the grading of posterior segment inflammation (dual fluorescein and ICG angiographic scoring system for uveitis). Int Ophthalmol Sep 16. [Epub ahead of print]Google Scholar
  20. 20.
    Mumcu G, Ergun T, Inanc N, Fresko I, Atalay T, Hayran O, Direskeneli H (2004) Oral health is impaired in Behçet’s disease and is associated with disease severity. Rheumatology (Oxford) 43:1028–1033CrossRefGoogle Scholar
  21. 21.
    Mumcu G, Sur H, Inanç N, Karacayli U, Cimilli H, Sisman N, Ergun T, Direskeneli H (2009) A composite index for determining the impact of oral ulcer activity in Behçet’s disease and recurrent aphthous stomatitis. J Oral Pathol Med 38:785–791PubMedCrossRefGoogle Scholar
  22. 22.
    Mumcu G, Inanc N, Ergun T, Ikiz K, Gunes M, Islek U, Yavuz S, Sur H, Atalay T, Direskeneli H (2006) Oral health related quality of life ıs affected by disease activity ın Behçet’s disease. Oral Dis 12:145–151PubMedCrossRefGoogle Scholar
  23. 23.
    Mumcu G, Hayran O, Ozalp Do, Inanc N, Yavuz S, Ergun T, Direskeneli H (2007) The assessment of oral health related quality of life by factor analysis in patients with Behçet’s disease and recurrent apthous stomatitis. J Oral Pathol Med 36:147–152PubMedCrossRefGoogle Scholar
  24. 24.
    McGrath C, Hegarty AM, Hodgson TA, Porter SR (2003) Patient-centered outcome measures for oral mucosal disease are sensitive to treatment. Int J Oral Maxillofac Surg 32:334–336PubMedCrossRefGoogle Scholar
  25. 25.
    Mumcu G (2008) Behçet’s disease: a dentist’s overview. Clin Exp Rheumatol 26(Suppl 50): S121–S124PubMedGoogle Scholar
  26. 26.
    Hatemi G, Silman A, Dang B, Bodaghi B, Chamberlain AM, Gul A, Houman MH, Kötter I, Olivieri I, Salvarani C, Sfikakis PP, Siva A, Stanford MR, Stübiger N, Yurdakul S, Yazici H (2008) EULAR recommendation for the management of Behçet’s disease. Ann Rheum Dis 67:1656–1662PubMedCrossRefGoogle Scholar
  27. 27.
    Karacayli U, Mumcu G, Simsek I, Pay S, Kose O, Erdem H, Direskeneli H, Gunaydin Y, Dinc A (2009) The close association between dental and periodontal treatments and oral ulcer course in Behçet’s disease: a prospective clinical study. J Oral Pathol Med 38:410–415PubMedCrossRefGoogle Scholar
  28. 28.
    Mumcu G, Niazi S, Stewart J, Hagi-Pavli E, Gokani B, Seoudi N, Ergun T, Yavuz S, Stanford MR, Fortune F, Direskeneli H (2009) Oral health and related quality of life status in patients from UK and Turkey: a comparative study in Behçet’s disease. J Oral Pathol Med 38:406–409PubMedCrossRefGoogle Scholar
  29. 29.
    Mumcu G, Inanc N, Ergun T, Islek U, Yavuz S, Fresko I, Sur H, Atalay T, Direskeneli H (2004) Gender effects quality of life in Behçet’s disease. Clin Exp Rheumatol 22(Suppl 34):S-86Google Scholar
  30. 30.
    Mioshi E, Dawson K, Mitchell J, Arnold R, Hodges JR (2006) The Addenbrooke’s Cognitive Examination Revised (ACE-R): a brief cognitive test battery for dementia screening. Int J Geriatr Psychiatry 21:1078–1085PubMedCrossRefGoogle Scholar
  31. 31.
    Siva A, Kantarci OH, Saip S, Altintas A, Hamuryudan V, Islak C, Kocer N, Yazici H (2001) Behçet’s disease: diagnostic and prognostic aspects of neurologic involvement. J Neurol 248:95–103PubMedCrossRefGoogle Scholar
  32. 32.
    Moses Alder N, Fisher M, Yazici Y (2008) Behçet’s syndrome patients have high levels of functional disability, fatigue and pain as measured by a Multi-dimensional Health Assessment Questionnaire (MDHAQ). Clin Exp Rheumatol 26(Suppl 50):S110–S113PubMedGoogle Scholar
  33. 33.
    Bodur H, Borman P, Ozdemir Y, Atan C, Kural G (2006) Quality of life and life satisfaction in patients with Behçet’s disease: relationship with disease activity. Clin Rheumatol 25:329–333PubMedCrossRefGoogle Scholar
  34. 34.
    Gilworth G, Chamberlain MA, Bhakta B, Haskard D, Silman A, Tennant A (2004) Development of the Behçet’s disease quality of life, a quality of life measure specific to Behçet’s disease. J Rheumatol 31:931–937PubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  • Gonca Mumcu
  • Yusuf Yazıcı
    • 1
  • M. Anne Chamberlain
  1. 1.New York University School of Medicine, NYU Hospital for Joint DiseasesNew YorkUSA

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