Behçet's disease laboratory findings
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Hamid Qazi, MD, BSc [2]
Overview
The laboratory tests used to diagnose Behçet's disease are a pathergy test, a skin biopsy, and a lumbar puncture.
Laboratory Findings
- Pathergy test: During this procedure, the skin of the forearm is pricked with a sterile needle. After 24~48 hours, a red nodule or pustule greater than two millimeters in diameter suggests positive and Behçet's syndrome.[1]
- Skin biopsy: Skin biopsy is used to diagnose a skin condition such as a rash and exclude skin cancer. During the procedure, a thin slice off the top of the skin is taken and the lesions are removed.
- Lumbar puncture: When the presentation is a severe headache and head CT is normal, then lumbar puncture can be done to exclude other center nervous diseases of headache. During this procedure, the patient lies on the side, with knees pulled up toward the chest, and chin tucked downward. After injecting the anesthetic into the lower spine, the doctor inserts a spinal needle into the lower back area to measure CSF pressure and collect a sample.[2]
- No specific laboratory test result is diagnostic of Behçet syndrome.
- Serum complement levels are within the reference range, except for just prior to eye or mucous membrane involvement, at which time they may be decreased.
- Sedimentation rate or C-reactive protein may be elevated. Chronic anemia common, and a neutrophil leukocytosis is seen in about 15% of patients.
- Human leukocyte antigen (HLA)-B51 may be present in patients of Asian, Mexican, or Middle Eastern descent.[3]
- Anticardiolipin antibodies are present in as many as 30% of patients.
- Systemic lupus erythematosus and other vasculitic syndromes must be ruled out. Patients with Behçet syndrome have negative antinuclear and antineutrophilic cytoplasmic antibodies.
- In patients with CNS findings, cerebral spinal fluid pleocytosis may be present.
- In addition to thrombosis associated with antiphospholipid antibodies, thrombosis has been reported in Behçet syndrome associated with factor V Leiden mutations and with prothrombin G20210A mutations.[2][4]
References
- ↑ Assar S, Sadeghi B, Davatchi F, Ghodsi SZ, Nadji A, Shahram F; et al. (2017). "The association of pathergy reaction and active clinical presentations of Behçet's disease". Reumatologia. 55 (2): 79–83. doi:10.5114/reum.2017.67602. PMC 5442298. PMID 28539679.
- ↑ 2.0 2.1 Seyahi E, Cakmak OS, Tutar B, Arslan C, Dikici AS, Sut N; et al. (2015). "Clinical and Ultrasonographic Evaluation of Lower-extremity Vein Thrombosis in Behcet Syndrome: An Observational Study". Medicine (Baltimore). 94 (44): e1899. doi:10.1097/MD.0000000000001899. PMC 4915888. PMID 26554787.
- ↑ Akpolat T, Koç Y, Yeniay I, Akpek G, Güllü I, Kansu E; et al. (1992). "Familial Behçet's disease". Eur J Med. 1 (7): 391–5. PMID 1341477.
- ↑ Saadoun D, Wechsler B, Resche-Rigon M, Trad S, Le Thi Huong D, Sbai A; et al. (2009). "Cerebral venous thrombosis in Behçet's disease". Arthritis Rheum. 61 (4): 518–26. doi:10.1002/art.24393. PMID 19333987.