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It has been suggested that the marked cellular inflammatory response, which characterises Behcet’s syndrome (BS), may be attributable to increased neutrophil locomotion.1-4However, others disagree.5 6 We have re-evaluated chemotaxis of polymorphonuclear leucocytes (PMNs) in BS among a greater number of patients in a controlled setting. Fifty four male BS patients, nine male patients with ankylosing spondylitis, eight with psoriasis and 37 male healthy controls were studied with 28 female patients with BS and 16 healthy female controls. Behcet patients with severe disease were those with active major vessel and/or eye involvement. We measured chemotaxis with the “under the agarose method”.7 8 The measurements were masked with the assessors not knowing the diagnoses. An inverted microscope fitted with an ocular micrometre disc to measure the migration of neutrophils from middle …

A prospective study of arthritis was performed in 47 patients with Behçet's disease followed up over a 47-month period (mean 19.25 months, SD 14.09). These patients had a total of 80 episodes of arthritis, which were analysed for joint distribution and symmetry, in 56 of which the duration could also be determined. Attacks were oligoarticular, affecting up to 4 joints per patient, 54 (68%) being monoarticular. Knees, ankles, and wrists were the most commonly involved joints. Involvement of spinal, shoulder, hip, and sacroiliac joints was rare. The arthritis was usually not deforming and subacute; 82% (46/56) of the attacks lasted for 2 months or less and 18% (10/56) for between 3 months and 4 years. The ESR was moderately elevated during the attacks. In 32 specimens the synovial fluid was inflammatory (cell count 14.7 +/- 10.1 x 10(9)/l), but in 19 (59%) a good mucin clot formed. Synovial biopsy in 12 patients revealed superficial ulceration, paucity of plasma cells, and in 5 instances lymphoid follicle formation.

Eye disease, arthritis, folliculitis, and thrombophlebitis were more common among males, and erythema nodosum among females, in 297 patients with Behćet syndrome (BS) at their first visit despite an identical disease duration. Younger males and females (age of onset 24 years or less) had a higher prevalence of eye disease and total clinical activity than did the older patients (age of onset 25 years or more). Among the 51 patients followed up for 52 months (SD 7 months) the total clinical activity became significantly less (p less than 0.05) in the whole group at the end of this period. This was particularly true for older females. While male sex and a younger age of onset are associated with more severe disease in BS, overall, the syndrome ran an improving or stable course over 4 1/2 years.

Forty-eight Turkish and 12 British patients along with 24 Turkish and 7 British healthy controls were assessed for the presence of the pathergy phenomenon. A photographic method with 'blind' reading was utilised. The pathergy phenomenon was present only among the Turkish patients.