How is Behcet's disease diagnosed?

Behcet's disease is a relatively rare immune system disease that affects people between the ages of 20 and 40. Behcet's disease is very complex and involves many parts of the human body, such as the gastrointestinal tract, cardiovascular system, pulmonary artery, etc. Behcet's disease is a relatively serious disease, and understanding its cause will help us better prevent it. So, how do you get Behcet's disease? Let’s take a look below.

Behcet's disease, an autoimmune disease, also known as Behcet's disease, is a chronic systemic disease with the basic pathological change being vasculitis. Clinically, recurrent oral ulcers, genital ulcers, skin and eye lesions are the most common, but all organs in the body can be affected. Behcet's disease is also known as the Silk Road disease because its incidence rate is high in Japan, China, Türkiye, Iran and other places, and the range of the disease basically coincides with the route of the ancient Silk Road. Although the disease is relatively rare, it can easily lead to lesions in various systems throughout the body. In severe cases, it can cause complete blindness, brain atrophy, and even death.

The main symptoms are recurrent oral ulcers, recurrent genital ulcers, and uveitis. Most patients will eventually become blind. The disease has a higher incidence in mid-latitude areas, such as Turkey, and the physician who named the disease was a Turk. The National Health Insurance lists this disease as one of the major injuries. This disease has a high correlation with HLA-B51.

The local area of ​​the eye is treated as usual for uveitis. Topical administration of glucocorticoids, such as 0.5% dexamethasone eye drops, can be applied frequently to the eyes, and eye ointment can be used before bedtime. Oral administration is preferred for systemic administration, and intravenous administration should be avoided as much as possible. In principle, large doses should be used for a short period of time, and the dosage should be gradually reduced after relief. Combined use with immunosuppressive drugs can not only enhance the therapeutic effect, but also reduce their respective dosages and side effects. Opinions vary regarding the choice of immunosuppressive drugs. Among alkylating immunosuppressive drugs such as cyclophosphamide, azathioprine, and chlorambucil, chlorambucil has the best efficacy. The initial daily dose is 0.1-0.15 mg/(kg·d) and continued for 5-6 months, or gradually reduced after the inflammation is controlled for 3-4 months, and finally reduced to a maintenance dose of 2 mg/d. The entire course of treatment lasts more than 1 year. Blood counts should be checked regularly during medication. If the total white blood cell count decreases sharply, or adverse reactions such as optic disc edema, retinal hemorrhage, etc. occur in the fundus, the drug should be discontinued. In addition, tumors may cause infertility, so the consent of the patient and his or her family should be obtained before using the medication. It is contraindicated in patients with impaired renal function. Japanese scholars have a high opinion of cyclosporine, and the reduction in severe cases is related to the widespread use of cyclosporine. However, attention must also be paid to its toxic side effects. It is contraindicated in patients with poor liver and kidney function, hypertension that cannot be controlled by antihypertensive drugs, and pregnant women. In addition, cyclosporine A can easily cause damage to the nervous system, so it is not suitable for patients with neurological Behcet's disease or a history of neuropsychiatric illness. The immunomodulatory drug levamisole has its own characteristics for oral mucosal ulcers, leukocyte chemokine inhibitors, and colchicine has its own characteristics for skin nodular erythema. It can be used as an option for patients with lesions other than these eyes. The pathological basis of multi-organ damage in Behcet's disease is perivascular inflammation and endovascular inflammation. Laboratory examinations showed decreased fibrinolytic activity, hypercoagulation, increased immune complexes in the blood, and choroidal and retinal vein occlusions. Therefore, plasminogen activators, platelet aggregation inhibitors, etc. are given according to the condition; when ineffective, plasmapheresis can be tried.