The Correlation with Enthesitis and the Severity of the Disease in Behçet’s Syndrome

Objective: The aim of this study was to determine the fre- quency of enthesitis using the Maastricht Ankylosing Spondylitis Enthesitis Score and the intensity of enthesitis with Maastricht Ankylosing Spondylitis Enthesitis Score in patients with Behçet’s syndrome, to examine the relationship with Behçet’s syndrome severity, and to evaluate whether enthesitis and higher enthesi- tis scores are associated with more severe disease. Methods: The study included 232 Behçet’s syndrome patients and 139 healthy control subjects. The presence of enthesitis in Maastricht Ankylosing Spondylitis Enthesitis Score-defined areas was evaluated using the standard palpation method. In the group with enthesitis, the intensity was assessed with Maastricht Ankylosing Spondylitis Enthesitis Score. Krause’s assessment of Behçet’s syndrome activity was used to evalu- ate the severity of Behçet’s syndrome. The Krause’s scores were compared between the groups, and then correlations were investigated between the Krause score and Maastricht Ankylosing Spondylitis Enthesitis Score in the enthesitis group. Results: Enthesitis was present in 23.2% of patients with Behçet’s syndrome. Both enthesitis frequency and Maastricht Ankylosing Spondylitis Enthesitis Scores were higher in Behçet’s syndrome patients compared to the healthy control group. Behçet’s syndrome patients with enthesitis had higher Krause’s scores (P < .001), vascular involvement (P = .001), arthritis (P = 01), papulopustular lesion (P = .01), and ocular involvement (P = .014). A correlation was determined between Krause’s score and Maastricht Ankylosing Spondylitis Enthesitis Score in the Behçet’s syndrome patients with enthesitis. Conclusion: The results of this study showed that Behçet’s syndrome patients with enthesitis could have a severe Behçet’s syndrome clinical condition. When evaluating Behçet’s syndrome patients, patients should be examined in terms of enthesitis as those with enthesitis may have a more severe disease course.