The proportional Venn diagram of Behçet’s disease-related manifestations among young adult men in Turkey

A. Dinc¹, A. Bayir², I. Simsek¹, H. Erdem¹, S. Pay¹, M. Turan³

¹Department of Medicine, Division of Rheumatology, ²Military Medical Faculty, and ³Department of Medical Ecology and Hydroclimatology, Gülhane Military School of Medicine, Etlik/Ankara, Turkey

ABSTRACTAyhan Dinc, MD, Associate Professor; Aytekin Bayir, MD, General Practitioner; Ismail Simsek, MD, Fellow in Rheumatology; Hakan Erdem, MD, Assistant Professor; Salih Pay, MD, Associate Professor; Mustafa Turan, MD, Professor.
Please address correspondence and
reprint requests to: Ayhan Dinc, MD, GATA Romatoloji Bilim Dali, 06018
Etlik-Ankara, Turkey.
E-mail: adinc@gata.edu.tr
Received on March 3, 2005; accepted
in revised form on July 14, 2005.
Clin Exp Rheumatol 2005; 23 (Suppl. 38): S86-S90.
© Copyright Clinical and Experimental Rheumatology 2005.

Key words: Behçet’s disease, Venn diagram, classification, diagnosis, criteria.


Objectives
To determine the frequency of the features associated with Behçet’s disease (BD) in a young men population and generate a proportional Venn diagram of those features.

Methods
Data was collected from 3714 otherwise healthy men recruited for military service at the entrance. Study was conducted in a two-step procedure. Firstly, all participants were questioned by a general practitioner via using visual Behçet’s questionnaire. Those participants, in whom at least one BD-related manifestation of the disease (oral ulcer, genital ulcer, folliculitis, erythema nodosum, uveitis, venous involvement of the lower extremities) have been demonstrated, were further examined by a rheumatologist at the second-stage of the study.

Results
The areas of intersection among the 6 individual BD-related manifestations produced 63 mutually exclusive symptom groups. Sixteen out 63 of these groups were functionally operative in our study population. Forty-seven (1.2%) of the all participants were considered to have at least 1 of the BD-related manifestation after examined by rheumatologist. The prevalence rates of the individual manifestations among the study population were as follows; oral ulcer 29 (0.78%), folliculitis 31 (0.83%), genital ulcer 9 (0.24%), venous involvement 13 (0.35%), erythema nodosum 4 (0.10%) and uveitis 3 (0.08%). The group consisting of oral ulcer with folliculitis was the largest proportion of participants followed by the group having oral ulcer only, accounting for 0.29% and 0.18%, respectively. Four (0.1%) of the participants were fulfilled the International Study Group for BD criteria following rheumatologic and ophthalmologic examinations. After excluding the group having oral ulcer with folliculitis, additional 12 cases had features suggesting BD though they didn’t fulfill the International Study Group for BD criteria.

Conclusion
The Venn diagram of this study demonstrates that International Study Group for BD criteria can detect almost the quarter of 16 cases suspected as having BD. We suggest that the application of information regarding the frequencies of individual BD-related manifestations and their association with each other in a general population might serve as a helpful tool for physicians while making diagnosis.

Key words
Behçet’s disease, Venn diagram, classification, diagnosis, criteria.

Please address correspondence and reprint requests to: Ayhan Dinc, MD, GATA Romatoloji Bilim Dali, 06018 Etlik-Ankara, Turkey.
E-mail: adinc@gata.edu.tr

Clin Exp Rheumatol 2005; 23 (suppl. 38): S86-S90.
© CLINICAL AND EXPERIMENTAL RHEUMATOLOGY 2005.