Clinical characteristics of behçet’s disease in palestine, a retrospective cohort study

TL;DR

This study describes the clinical features and complications of Behçet’s Disease in Palestine, highlighting common symptoms and outcomes.

Contribution

The study provides the first detailed clinical characterization of Behçet’s Disease in Palestine.

Findings

Oral and genital ulcers were the most common initial symptoms in Palestinian BD patients.

Vascular events and visual impairment were the most frequent complications observed.

Neurological and neuropsychiatric complications were less common and showed no gender differences.

Abstract

Behçet’s Disease (BD) is a chronic, systemic vasculitis of unknown etiology that affects multiple organ systems. It is characterized by recurrent oral and genital ulcers, ocular involvement, affecting arteries and veins of all sizes. It is more prevalent in countries along the ancient Silk Road. Diagnosis is primarily clinical, as there are no specific laboratory tests. The International Criteria for BD (ICBD) was developed to improve diagnostic accuracy. Management requires a multidisciplinary approach, with treatment strategies depending on disease severity. Despite BD’s significant morbidity and diverse clinical manifestations, its prevalence and characteristics remain to be described in Palestine. This research provides critical insights into disease patterns and contributes to improved diagnosis and management in Palestine.

A retrospective cohort study was conducted in the period from Aug 2024 until March 2025 in rheumatology clinics across the West Bank and Jerusalem. 60 Patients diagnosed with BD based on ICBD (score ≥ 4) were included. Exclusion criteria were cognitive impairment, incomplete records, or non-residence in Palestine. Sixty patients were enrolled. Data was collected via chart review and patient interviews. Disease-related complications were assessed using the Behçet’s Overall Damage Index (BODI) to ensure standardized evaluation.

The male to female ratio was 1.14:1. In addition, the most common initial clinical presentations were oral aphthous ulcers (96.7%), genital aphthous (86.7%), ocular lesions (66.7%), skin lesions noted (46.7%), while vascular lesions occurred in (30%). Neurological manifestations and positive Pathergy test were (25%) and (18.3%), respectively. Regarding complications, the most common were vascular events (36.7%), skin ulcerations (33.3%), mucocutaneous scars (20%), avascular necrosis (13.3%), osteoporotic fractures (10%). Regarding complications in the eye, anterior segment changes presented (15%), posterior segment changes (8.3%), visual impairment in one eye (33.3%), and (13.3%) in both. Neurological complications were less frequent and there was no difference in characteristics between the genders.

The most common manifestations were oral aphthous ulcers, followed by genital ulcers, neurological manifestations, and pathergy was the least frequent. The most frequently reported complications were vascular events, skin ulceration, and visual impairment, while neuropsychiatric complications were the least frequent, and there was no gender difference in BD characteristics.

No trial registry number.

The online version contains supplementary material available at 10.1186/s41927-025-00544-5.