Clinical phenotypes of Behcet's syndrome in a large cohort of Italian patients: focus on gender differences

Objective: The aim of this study was to investigate the clinical phenotypes of Italian patients with Behcet's syndrome (BS) according to gender. BS is a rare chronic multisystemic disorder with a wide spectrum of clinical manifestations. Human leucocyte antigen (HLA)-B51, gender, and ethnicity have been suggested as factors that could influence the clinical manifestations in BS patients. To date, few data assessing gender differences in Italian BS patients are available in the literature. Method: We retrospectively evaluated a group of Italian patients seen consecutively at our dedicated tertiary centre from 1 January 2000 to 31 May 2018. Demographics, clinical features during follow-up, and HLA status were obtained from a review of medical records and analysed in male and female groups. Results: In total, 285 [168 male (M) and 117 female (F)] patients were eligible for the study. Males had papulopustolar lesions, posterior uveitis, and deep venous thrombosis more often than females (83.3% M vs 46.2% F, 36.9% M vs 18.8% F, and 8.3% M vs 0.9% F, respectively; p < 0.01). Erythema nodosum (59.0% F vs 41.1% M; p < 0.01) and arthralgia (52.1% F vs 31.6% M; p < 0.01) were more frequent in females. No differences were found in HLA-B51 status (59.2% M vs 59.0% F). Conclusion: In our Italian cohort, BS was slightly more prevalent in males. Some gender-related differences were observed when comparing male and female cohorts. The data also confirmed that BS tends to be less aggressive in Italian female patients.

Automated summary

This study aimed to investigate clinical phenotypes of Italian Behcet's syndrome (BS) patients by gender. Males were more likely to have papulopustolar lesions, posterior uveitis, and deep venous thrombosis, while females were more likely to have erythema nodosum and arthralgia. There were no significant differences in HLA-B51 status between male and female patients. BS tended to be less aggressive in Italian female patients.