Thrombophilic factors are not the leading cause of thrombosis in Behcet's disease

Background: Venous and arterial thromboses occur in patients with Behcet's disease and are associated with significant morbidity and mortality. Studies on a possible association between the occurrence of thrombosis and thrombophilia in patients with this disease have been controversial. Objective: To determine the prevalence of the most common thrombophilias and dyslipidaemia in patients with Behcet's disease with and without thrombosis. Methods: Blood samples from 107 patients with Behcet's disease who had or did not have thrombosis were analysed for factor V Leiden, prothrombin G20210A polymorphism, methylenetetrahydrofolate reductase (MTHFR) C677T polymorphism, factor VIII level, homocysteine and C reactive protein concentrations, dyslipidaemia, and plasma glucosylceramide. Results: There was no difference between patients with and without thrombosis in the prevalence of prothrombin G20210A polymorphism, factor V Leiden, homozygous MTHFR C677T, or plasma concentrations of homocysteine, C reactive protein, or glucosylceramide. In contrast, patients with thrombosis were found to have significantly higher mean levels of factor VIII, total cholesterol, triglycerides, VLDL cholesterol, and apolipoproteins B-100, C-II, and C-III than those without thrombosis. Multistepwise logistic regression analysis showed that triglyceride concentration was the best marker associated with thrombosis (p = 0.008), with an estimated odds ratio of 1.58 (95% confidence interval, 1.09 to 2.30) for a difference of 40 mg/dl. Conclusions: Thrombophilia does not seem to play a major role in the tendency to thrombosis in Behcet's disease. However, dyslipidaemia, predominantly hypertriglyceridaemia, might be a risk factor.