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Rheumatology Advance Access published online on June 11, 2008
Rheumatology, doi:10.1093/rheumatology/ken162
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© The Author 2008. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Behcet's disease associated with bone marrow failure in Korean patients: clinical characteristics and the association of intestinal ulceration and trisomy 8

J. K. Ahn1, H.-S. Cha1, E.-M. Koh1, S.-H. Kim2, Y. G. Kim3, C.-K. Lee3 and B. Yoo3

1Department of Medicine, 2Department of Laboratory Medicine and Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine and 3Department of Internal Medicine, Division of Rheumatology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.

Correspondence to: H.-S. Cha, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 IIwon-Dong, Gangnam-Gu, Seoul 135-710, Republic of Korea. E-mail: hoonsuk.cha{at}samsung.com


  Abstract

Objectives. The aim of this study was to determine the clinical characteristics of Behcet's disease (BD) associated with bone marrow failure (BMF), classified as conditions such as myelodysplastic syndrome (MDS) or aplastic anaemia (AA), in Korea.

Methods. A retrospective analysis was made of 13 patients with BD associated with BMF (MDS 8 cases, AA 5 cases) and 66 patients with BD not associated with BMF. These patients all fulfilled the diagnostic criteria of the international BD study group.

Results. BD patients with BMF showed significantly lower leucocyte count, haemoglobin level and platelet count when compared with patients without BMF (P < 0.001). BD patients with BMF had significantly higher serum CRP level at the time of BD diagnosis compared with patients without BMF (P = 0.03). Intestinal lesions were more frequent in BD patients with BMF than those without BMF (61.5% vs 13.6%, P = 0.001). Cytogenetic abnormality was observed in 90.9% of BD patients with BMF. Of the cytogenetic abnormalities, trisomy 8 was most common, occurring in 70% of the patients. In four patients with refractory BD associated with BMF, successful treatment of BMF by haematopoietic stem cell transplantation resulted in clinical remission of BD.

Conclusions. Our study indicates that intestinal ulceration is a characteristic finding in BD associated with BMF. It also suggests that cytogenetic aberration, especially trisomy 8, may play an important role in the pathogenesis of BD associated with BMF.

KEY WORDS: Behcet's disease, Myelodysplastic syndrome, Aplastic anaemia, Intestinal ulceration, Trisomy 8

Submitted 31 December 2007; revised version accepted 31 March 2008.
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