COEXISTENCE OF BEHÇET’S DISEASE AND ANKYLOSING SPONDYLITIS: CASE REPORT AND REVIEW OF THE LITERATURE

SINAN KARDE޹, MINE KARAGÜLLE¹, MÜFIT ZEKI KARAGÜLLE¹, NERGIS ERDOĞAN¹

¹ Department of Medical Ecology and Hydroclimatology, Istanbul Faculty of Medicine, Istanbul University, Turkey

Objective: To review the clinical characteristics, genetic features and treatments of the previously reported cases of Behçet's disease and ankylosing spondylitis with additional one case presentation.

Method: Pubmed, Web of Science and Google Scholar databases were interrogated.

Results: A total of 23 cases with coexistence of Behçet’s disease and ankylosing spondylitis were found and afterwards reviewed. The majority of them involved male subjects (82.6%). All patients had mucocutaneous lesions and sacroiliitis, 54.5% of all patients had eye involvement, 68.4% had positive pathergy test, 75% had peripheral arthritis and 55.6% of patients developed ankylosing spondylitis after Behçet’s disease. Tumor necrosis factor inhibitors were used in six cases. HLA-B51 was positive in 57.1% and HLA-B27 in 59.1% of all cases.

Conclusion: Even though Behçet's disease has some clinical and genetic features in common with spondyloarthritis, there remains no sufficient evidence that phenotypes of these shared features are identical or these features are traced to a similar pathogenesis. By taking into account all previously reported cases and our presented case, we suggest that ankylosing spondylitis should be considered in differential diagnosis as a coexisting condition when a Behçet’s disease patient with low back pain is being examined.