Behçet's syndrome is not associated with vitiligo
Department of Internal Medicine, Cerrahpasa Medical School, Istanbul University, Istanbul, Turkey. Clinical and experimental rheumatology
(Impact Factor: 2.72).
07/2008; 26(4 Suppl 50):S107-9.
Behçet's syndrome (BS) has many features that are different from autoimmune diseases, including a lack of association with Sjögren's syndrome. Vitiligo is frequently associated with various autoimmune disorders such as autoimmune thyroiditis, pernicious anemia and Addison's disease. Our informal observation was that vitiligo is also uncommon among BS patients. With this controlled and masked study we formally surveyed the presence of vitiligo among BS patients and suitable controls.
Patients with Behçet's syndrome, Graves' disease, and Hashimoto's thyroiditis being followed in the rheumatology and endocrinology departments of a university hospital and healthy controls were examined. Subjects with hypopigmented lesions were re-examined by a dermatologist in a masked protocol. Wood's lamp was used to confirm the diagnosis of vitiligo in suspected lesions.
253 consecutive BS patients, 34 Graves' disease patients, 32 Hashimoto's thyroiditis patients, and 439 healthy controls were surveyed. None of the BS patients had vitiligo, while 6/34 (17.6%) of Graves' disease patients, 6/32 (18.7%) of Hashimoto's thyroiditis patients, and 4/439 (0.9%) of healthy controls had vitiligo. All the subjects with vitiligo, except for one patient with associated Graves' disease, were women.
In contrast to two autoimmune diseases, Hashimoto's thyroiditis and Graves' disease, the frequency of vitiligo was not increased among patients with BS. This constitutes further evidence that traditional autoimmune mechanisms may not be operative in BS.
Available from: Nahide Onsun
- "According to these data, Behçet's disease does not have the classical clinical features of autoimmunity such as anti-nuclear antibody positivity, female dominance, and any association with other autoimmune diseases such as Sjögren's syndrome, vitiligo. Another features distinguishing BD from autoimmune conditions are the lack or paucity of serositis, glomerulonephritis, Raynaud's phenomenon, the lack of organ-specific, nonspecific autoantibodies , B-cell hyperfunction, T-cell hypofunction, the lack of HLA alleles associated with autoimmune diseases, and a distinct geographic distribution   . On the other hand, the association between BD and other autoimmune diseases is not well documented in the literature. "
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Behcet's disease (BD) could be regarded as an autoimmune disease in many aspects. Autoimmune thyroid disease (ATD) is frequently accompanied by other various autoimmune diseases. Nevertheless, there is not still enough data showing the association between BD and ATD. In addition, no controlled study is present in the PubMed, which evaluates thyroidal autoimmunity using antithyroid peroxidase antibody in a large series of patients with BD.
We aimed to investigate the frequency of ATD in patients with BD. The study included 124 patients with BD and 99 age- and sex-matched healthy volunteers.
Autoimmune thyroiditis was noted in 21 cases (16.9%) with BD. In the control group, 22 cases (22.22%) were diagnosed as autoimmune thyroiditis. There was no difference between the groups in respect to thyroid autoantibodies (P>0.05). There were no statistically significant differences between baseline TSH levels of the BD patients and of the controls (P>0.05). Statistically, the mean serum free T4 levels of the patients with BD were higher than those of the controls (P<0.001).
No association could be found between BD and ATD. Therefore, it is not of significance to investigate thyroid autoimmunity in BD.
Available from: Huseyin Bayramlar
- "The frequency of autoimmune thyroid disease is increased among vitiligo patients and their first-degree relatives  and the frequency of vitiligo is higher among patients with Hashimoto's thyroiditis and Graves' disease . Oran et al. reported that the frequency of vitiligo was not increased among patients with BD . They claimed that traditional autoimmune mechanisms might not be operative in BD. "
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ABSTRACT: Behçet's disease (BD) and vitiligo are diseases of unknown etiology. Interferon (IFN) alpha therapy is commonly used in Behçet uveitis. Interferon treatment in various diseases have also been observed causing certain autoimmune diseases such as vitiligo because of its immunomodulatory activity. The association between IFN therapy and vitiligo has been reported in the literature. We report a 21-year-old man with BD in whom vitiligo occurred during IFN treatment. To the best of our knowledge, this is the first reported case of such an association.
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ABSTRACT: Behçet's syndrome (BS) is a disease of unknown etiology, and as such, there have been efforts to classify BS within the popular nosological identities of the times such as seronegative spondarthritides, autoimmune, and more recently autoinflammatory diseases. Current evidence suggests that BS does not easily fit into any one of these lumps, while on occasion, it might be impossible to tell BS from Crohn's disease, especially when the main clinical presentation is intestinal ulceration. There are distinct regional differences in disease expression of BS with fewer cases of intestinal disease in the Mediterranean basin and less severe eye disease and less frequent skin pathergy among patients reported from northern Europe or America. The clustering of symptoms, especially with the recently described increased frequency of the acne/arthritis cluster in familial cases, suggests that more than one pathological pathway is involved in what we call BS today. Supportive evidence for this contention also comes from the observations that (a) the genetic component is very complex with perhaps different genetic modes of inheritance in the adult and in the pediatric patients; and (b) there are differing organ responses to one same drug. For example, the anti-TNF agents successfully control the oral ulcers while they have no effect on the pathergy reaction.
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