Behçet's Disease in Patients of German and Turkish Origin Living in Germany: A Comparative Analysis

INA KÖTTER, REINHARD VONTHEIN, CLAUDIA A. MÜLLER, ILHAN GÜNAYDIN, MANFRED ZIERHUT, and NICOLE STÜBIGER

ABSTRACT.

Objective. To evaluate the relationship between ethnic origin and manifestations of Behçet's disease (BD) in patients of German and Turkish origin living in Germany.

Methods. Between 1995 and 2000, 32 patients of German and 33 patients of Turkish origin living in Germany were evaluated for the entire spectrum of disease manifestations, disease severity, HLA associations, sex, age at disease manifestation, and time to diagnosis.

Results. There were no statistically significant differences between German and Turkish patients. There was no association of sex or HLA-B51 with any manifestation of BD. The only significant difference between the 2 groups was the median time from the first manifestation of the disease to diagnosis, which was 0 years for the Turkish, but 3.5 years for the German patients (p = 0.0005). Additionally, 4 patients of German origin had been misdiagnosed as having spondyloarthropathy (SpA) before the final diagnosis of BD was made (12%). In comparison to Turkish patients living in Turkey (data from the literature), only 2 differences were found: one concerned the frequency of ocular involvement (lower in the patients in Turkey), and the other the male to female ratio, which was reported as 1.03:1 in Turkey, but 3.7:1 in Germany.

Conclusion. Our results do not favor an ethnic influence on the expression of BD. Environmental influences may be responsible for the higher frequency of ocular manifestations and the higher male to female ratio in patients living in Germany compared to those living in Turkey. (J Rheumatol 2004;31:133-9)

Key Indexing Terms:

BEHÇET'S DISEASE
DISEASE SPECTRUM
HLA-B51 ASSOCIATION
GERMAN AND TURKISH ORIGIN

---

From the Department of Internal Medicine II (Haematology, Oncology, Immunology, and Rheumatology); the Section of Transplantation Immunology and Immunohaematology; and the Department of Ophthalmology II, University Hospital; and the Department of Medical Biometry, University of Tübingen, Tübingen, Germany.

I. Kötter, MD; I. Günaydin, MD, Department of Internal Medicine II; R. Vonthein, PhD, Department of Medical Biometry; C.A. Müller, MD, Section of Transplantation Immunology and Immunohaematology; M. Zierhut, MD; N. Stübiger, MD, Department of Ophthalmology II.

Address reprint requests to Dr. I. Kötter, Department of Internal Medicine II, University Hospital, Otfried-Müller Str. 10, D-72076 Tübingen, Germany. E-mail: ina.koetter@med.uni-tuebingen.de

Submitted December 19, 2002; revision accepted June 16, 2003.

---