Turkiye Klinikleri Journal of Dermatology

.: ORIGINAL RESEARCH
Frequency of HLA-B51 in Behçet's Patients and Relationship with Clinical Findings
Behçet Hastalarında HLA-B51 Sıklığı ve Klinik Bulgularla İlişkisi
Fatma TUNÇEZ AKYÜREKa, Nadir KOÇAKb
Departments of
aDermatology,
bMedical Genetics, Selçuk University Faculty of Medicine, Konya, TÜRKİYE
Turkiye Klinikleri J Dermatol. 2019;29(3):108-12
doi: 10.5336/dermato.2019-70625
Article Language: EN
Full Text
ABSTRACT
Objective: The most important genetic factors known in the pathogenesis of Behçet's disease (BD) is HLA-B51. It has been shown that HLA-B51 positivity is high in countries on the 'Silk Road' where BD is frequent. HLA-B51 is thought to be a prognostic marker that is related to severe clinical forms of BD. In this study, we aimed to investigate the prevalence of HLA-B51 positivity in patients diagnosed with BD and the relationship between the demographic and clinical findings of the patients. Material and Methods: Between March 2013 and 2018, the files of the patients who were diagnosed with BD according to the criteria of the International Study Group for Behçet Disease in dermatology polyclinic of Selçuk University Medical Faculty were reviewed retrospectively. Forty-seven patients (22 women and 25 men) with HLA-B51 were included in the study. Results: In our study, no correlation was found between HLA-B51 positivity and gender, age at onset, family history, clinical findings (such as oral and genital ulcer, papulopustular eruption, erythema nodosum, pathergy test positivity, thrombophlebitis, ocular involvement, arthritis) and systemic manifestations. Conclusion: In previous studies, conflicting results have been reported on the relationship between HLA-B51 and BD manifestations in different ethnic groups. In our study, no statistically significant correlation was found between HLA-B51 positivity and demographic and clinical findings of Behçet patients. We believe that there is a need for larger comparative prospective studies investigating the relationship between HLA-B51 and BD in different ethnic groups.

Keywords: Behçet's disease; HLA-B51
ÖZET
Amaç: Behçet hastalığının (BH) patogenezindeki bilinen genetik faktörlerin en önemlisi HLA-B51'dir. Behçet hastalığının sık görüldüğü 'İpek yolu' üzerindeki ülkelerde HLA-B51 pozitifliğinin yüksek olduğu gösterilmiştir. HLAB-51'in, BH'nin şiddetli klinik formları ile ilişkili prognostik bir marker olabileceği düşünülmüştür. Bu çalışmada, BH tanısı ile takip edilen hastalarda, HLA-B51 pozitifliğinin sıklığı ve hastaların demografik ve klinik bulguları ile ilişkisini araştırmayı amaçladık. Gereç ve Yöntemler: Mart 2013-2018 tarihleri arasında Selçuk Üniversitesi Tıp Fakültesi dermatoloji polikliniğinde takip edilen, Uluslararası Behçet Hastalığı Çalışma Grubu kriterlerinine göre BH tanısı olan hastaların dosyaları retrospektif olarak incelendi. HLA-B51 bakılan 47 hasta (22 kadın ve 25 erkek) çalışmaya dahil edildi. Bulgular: Çalışmamızda HLA-B51 pozitifliği ile cinsiyet, başlangıç yaşı, aile öyküsü, klinik bulgular (oral ve genital ülser, papülopüstüler erüpsiyon, eritema nodozum, paterji testi pozitifliği, tromboflebit, oküler tutulum, artrit gibi) ve sistemik bulgular arasında bir ilişki bulunmadı. Sonuç: Daha önceki çalışmalarda, farklı etnik gruplarda, HLA-B51'in BH'nin klinik bulguları arasındaki ilişkiyle ilgili çelişkili sonuçlar bildirilmiştir. Bizim çalışmamızda HLA-B51 pozitifliği ile Behçet hastalarının demografik ve klinik özellikleri arasında istatistiksel olarak anlamlı bir ilişki bulunamamıştır. Bu nedenle HLA-B51 ile BH'nin ilişkisini araştıran farklı etnik grupları kapsayan daha geniş karşılaştırmalı prospektif çalışmalara ihtiyaç vardır.

Anahtar Kelimeler: Behçet hastalığı; HLA-B51
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