Behcet's Disease in Afghan immigrants of Iran; Report of 12 cases.


Abstract: Introduction: Behcet's Disease (BD) is mainly seen in the countries along the Silk Rout. Among Asian countries, there is no data from Afghanistan on the clinical features of BD. Near 2 million Afghan immigrants live in Iran. This is a report on the clinical features of the disease in them with a comparison to the Iranian patients. Patients & Methods: All Afghan patients with BD referred to our BD unit during the past 10 years were selected. Different manifestations of the disease, including 100 clinical and paraclinical parameters, were controlled. A confidence interval (CI) at 95% was calculated for each item. These data were compared with the Iranian patients by the chi square test. Results: There were 12 Afghan patients with BD. The male to female ratio was 1.4/1. The mean age at the onset of the disease was 23.4+8 yr. The mean disease duration was 5.9+5.2 yr., and the mean follow up time was 1.3±1.2 yr. As the first manifestation of the disease oral aphthosis was seen in 10 patients (83%, CI=21) , genital aphthosis in 1 (8%, CI=15), uveitis and pseudofoiliculitis each in 2 patients (17%, CI=21). The prevalence of clinical signs were as follow: Mucous membrane lesions all 12 cases (oral aphthosis in 12, genital aphthosis in 2); skin lesions in 5 (42%, CI=28) (pseudofolliculitis in 4, erythema nodosum in 1); ocular lesions in 8 (67%, CI=27) (anterior uveitis in 5, posterior uveitis in 7, retinitis in 6); joint, GI and cardiac involvement each in 1 case. No vascular, neurologic, pulmonary involvement or orchi-epididymitis was seen. In Laboratory tests: Pathergy test was positive in 50% (CI=28), HLA-B5 in 42% (CI=28), HLA-B27 in 8%(CI=I5), high ESR in 42% (CI=28) and urinary abnormalities in 17% (CI=21). Comparison of these data with the 4130 Iranian patients with BD showed a lower frequency of genital aphthosis (p<0.002), skin lesions (p<0.04) notably pseudofolliculitis (p<0.05), and joint manifestation (p<0.02) in the Afghan patients. The other clinical and paraclinical data showed no significant difference between these two groups. Conclusion: BD is seen in Afghan patients (at least in their immigrants of Iran). The clinical feature of the disease in them is very similar to the Iranian patients with a lower frequency of genital aphthosis, skin lesions and joint manifestations. This similarity may contribute to the identical genetic background or environmental factors in the people of these two neighbor countries.