The Clinical Features of Arthritis in Behçet’s Disease

Abstract

Aim: This study aims to explore the clinical, laboratory, and systemic differences between Behçet’s disease (BD) patients with arthritis and those without, focusing on how arthritis influences disease progression and treatment strategies. Material and Methods: A retrospective, observational study was conducted on 881 patients diagnosed with BD according to the International Study Group criteria. Patients were categorized into two groups: those with arthritis (n=233) and those without (n=648). Clinical findings, laboratory markers [C-reactive protein (CRP), erythrocyte sedimentation rate (ESR)], and systemic manifestations, including neurological and vascular complications, were compared between the groups. Statistical analyses were performed to identify significant differences. Results: Patients with arthritis exhibited higher systemic inflammation, as evidenced by elevated ESR (37.6±23.9 vs. 31.1±23.9, p=0.000) and CRP (25.9±32.2 vs. 18.6±34.6, p=0.006) at baseline. Family history of BD was more prevalent in the arthritis group (15% vs. 10%, p=0.041). Neurological involvement was significantly higher in the non-arthritis group (11% vs. 4%, p=0.002), as were vascular complications, including: pulmonary artery aneurysms (2%, p=0.043) in the non-arthritis group and arterial thrombosis (5% vs. 1%, p=0.025). Patients with arthritis were more likely to receive corticosteroid therapy (36% vs. 21%, p=0.019), while pulse corticosteroid use was higher in the non-arthritis group (9% vs. 4%, p=0.008). Conclusion: BD patients with arthritis demonstrate heightened systemic inflammation, a stronger genetic predisposition, and greater reliance on corticosteroids. In contrast, those without arthritis have higher rates of severe systemic complications, including neurological and vascular involvement. These findings emphasize the importance of individualized management strategies tailored to the presence or absence of arthritis, addressing the diverse clinical spectrum of BD.