Vascular involvement in Behçet's disease: ultrasound assessment of femoral vein intima-media thickness, nailfold capillaroscopy and endothelial progenitor cells in a national referral centre

Clin Exp Rheumatol. 2023 Oct;41(10):2008-2016. doi: 10.55563/clinexprheumatol/qvkhi4. Epub 2023 Mar 2.

Abstract

Objectives: To assess vascular involvement at different levels in patients with Behçet's disease (BD).

Methods: We conducted an observational study of unselected consecutive patients with BD assessed in a national referral centre. Demographic and clinical variables were collected. Common femoral vein (CFV) intima-media thickness (IMT) was measured with a high-resolution Doppler ultrasound (US). Microvascular involvement was evaluated performing a nailfold capillaroscopy (NFC). Endothelial progenitor cells (EPC) were measured in peripheral blood of patients and healthy controls (HC) by flow cytometry.

Results: A total of 42 patients with BD were evaluated. Clinical vascular manifestations were present in 17 of them. Arterial hypertension was associated with a higher frequency of vascular manifestations (p=0.003). The median [IQR] value of the CFV IMT was significantly higher in patients with vascular manifestations (0.65 [0.45-0.82] vs 0.49 [0.39-0.55]; p= 0.028). The NFC examination was abnormal in 54.8% of the patients, being the most common findings: capillary loop dilation (45.2%), mega capillaries (21.4%) and micro haemorrhages (16.7%). A significant increase in EPC frequency was observed in patients with BD when compared with HC (p=0.011).

Conclusions: The assessment of CFV IMT with Doppler US constitutes a useful technique to evaluate clinical vascular involvement in BD patients. Microvascular involvement is not uncommon in BD and can be easily assessed by NFC. Furthermore, EPC may be a useful blood biomarker of the disease.

Publication types

  • Observational Study

MeSH terms

  • Behcet Syndrome* / diagnosis
  • Behcet Syndrome* / diagnostic imaging
  • Carotid Intima-Media Thickness
  • Endothelial Progenitor Cells*
  • Femoral Vein / diagnostic imaging
  • Humans
  • Microscopic Angioscopy