Abstract
Objective
Behçet’s disease (BD) is a multisystemic inflammatory disorder of unknown etiology that is sometimes associated with thrombosis. However, the mechanism of hypercoagulability is not known. In this study, we investigated whether hyperhomocysteinemia, being a well-known risk factor for thrombosis, is also a contributing risk factor to venous and arterial thromboses of BD.
Methods
Forty-five patients with BD and 40 healthy subjects were included in the study. Sixteen patients had vascular involvement. Serum homocysteine levels were determined by fluorescence polarization immunoassay.
Results
In male patients, the frequency of vascular involvement was significantly higher than in females (46.7% vs 13.3%, P<0.05). Serum homocysteine levels were significantly higher in patients with BD than healthy controls (P<0.01), in patients with vascular involvement than those with mucocutaneous involvement (P<0.01) and healthy controls (P=0.001), and in male patients than in female patients (P<0.001). There was no significant difference in homocysteine levels between the BD patients with mucocutaneous involvement and healthy subjects. In multiple regression analysis, serum homocysteine level was independently associated with thrombosis (odds ratio 1.29, P<0.01), but male sex was not.
Conclusions
This preliminary study suggests that elevated serum homocysteine levels may play some role in the development of venous and arterial thromboses in BD.
Similar content being viewed by others
References
Aydıntuğ AO (2001) Vascular manifestations in Behçet’s disease. In: Asherson RA, Cervera R (eds) Vascular manifestations of systemic autoimmune diseases. CRC, Boca Raton, pp 361–373
Leiba M, Sidi Y, Gur H, Leiba A, Ehrenfeld M (2001) Behçet’s disease and thrombophilia. Ann Rheum Dis 60:1081–1085
Hankey GJ, Eikelboom JW (1999) Homocysteine and vascular disease. Lancet 354:407–413
Durand P, Prost M, Loreau N, Lussier-Cacan S, Blache D (2001) Impaired homocysteine metabolism and atherothrombotic disease. Lab Invest 81:645–672
Dudman NP, Temple SE, Guo XW, Fu W, Perry MA (1999) Homocysteine enhances neutrophil-endothelial interactions in both cultured human cells and rats in vivo. Circ Res 84:409–416
den Heijer M, Koster T, Blom HJ, Bos GM, Briet E, Reitsma PH, Vandenbroucke JP, Rosendaal FR (1996) Hyperhomocysteinemia as a risk factor for deep-vein thrombosis. N Engl J Med 334:759–762
International Study Group for Behçet’s Disease (1990) Criteria for diagnosis of Behçet’s disease. Lancet 335:1078–1080
Gül A, Özbek U, Öztürk C, İnanç M, Koniçe M, Özçelik T (1996) Coagulation factor V mutation increases the risk of venous thrombosis in Behçet’s disease. Br J Rheumatol 35:1178–1180
Gül A, Aslantas AB, Tekinay T, Koniçe M, Özçelik T (1999) Procoagulant mutations and venous thrombosis in Behçet’s disease. Rheumatology 38:1298–1299
Hampton KK, Chamberlain MA, Menon DK, Davis JA (1991) Coagulation and fibrinolytic activity in Behçet’s disease. Thromb Haemost 66:292–294
Özoran K, Düzgün N, Gürler A, Tutkak H, Tokgöz G (1995) Plasma von Willebrand factor, tissue plasminogen activator, plasminogen activator inhibitor, and antithrombin III levels in Behçet’s disease. Scand J Rheumatol 24:376–382
Mader R, Ziv M, Adawi M, Mader R, Lavi I (1999) Thrombophilic factors and their relation to thromboembolic and other clinical manifestations in Behçet’s disease. J Rheumatol 26:2404–2408
Aksu K, Turgan N, Oksel F, Keser G, Ozmen D, Kitapçioglu G, Gumusdis G, Bayindir O, Doganavsargil E (2001) Hyperhomocysteinaemia in Behçet’s disease. Rheumatology 40:687–690
Lee YJ, Kang SW, Yang JI, Choi YM, Sheen D, Lee EB, Choi SW, Song YW (2002) Coagulation parameters and plasma total homocysteine levels in Behçet’s disease. Thromb Res 106:19–24
Korkmaz C, Bozan B, Kosar M, Sahin F, Gulbas Z (2002) Is there association of plasma homocysteine level with vascular involvement in patients with Behçet’s syndrome? Clin Exp Rheumatol 20 [Suppl 26]:S30–S34
Boushey CJ, Beresford SAA, Omenn GS, Motulsky AG (1995) A quantitative assessment of plasma homocysteine as a risk factor for vascular disease. Probable benefits of increasing folic acid intakes. JAMA 274:1049–1057
Monnerat C, Hayoz D (1997) Homocysteine and venous thromboembolism. Schweiz Med Wochenschr 127:1489–1496
Harpel PC, Zhang X, Borth W (1996) Homocysteine and hemostasis: pathogenic mechanisms predisposing to thrombosis. J Nutr 126 [Suppl 4]:1285–1289
den Heijer M, Brouwer IA, Bos GMJ, Blom HJ, van der Put NMJ, Spaans AP, Rosendaal FR, Thomas CMG, Haak HL, Wijermans PW, Gerrits WBJ (1998) Vitamin supplementation reduces blood homocysteine levels. A controlled trial in patients with venous thrombosis and healthy volunteers. Arterioscler Thromb Vasc Biol 18:356–361
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Ateş, A., Aydıntuğ, O., Ölmez, Ü. et al. Serum homocysteine level is higher in Behçet’s disease with vascular involvement. Rheumatol Int 25, 42–44 (2005). https://doi.org/10.1007/s00296-003-0398-9
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00296-003-0398-9