Prevalence of Behcet’s disease among adult patients consulting three major clinics in a Druze town in Israel

Abstract

To evaluate the prevalence of Behçet's disease (BD) in a Druze community in Israel, we conducted a two-stage clinic-based survey in an Israeli Druze town. The first stage aimed to identify patients with recurrent aphthous stomatitis (RAS) in all patients who visited three of the largest clinics in the town during a period of 6 months. The second stage aimed to identify those patients with RAS who fulfilled the diagnostic criteria for BD according to the International Study Group (ISG) criteria. One thousand and eighty-three out of about 4,000 registered subjects were interviewed, 63 of whom had RAS (5.8%). Two patients fulfilled the ISG criteria for BD, resulting in a calculated prevalence in the range of 2:1,083-2:4,000, i.e., 50-185:100,000. Another two patients with oral and genital aphthosis but without eye or skin lesions were diagnosed as suspected BD. The very high prevalence of BD, as found in our study, places the Druze among the populations with the highest prevalence of the disease all over the world, though selection biases could account for overestimation as well as underestimation of the actual BD prevalence. Our findings call for genetic studies to explore whether there is a genetic predisposition to BD in this population.

High burden of rheumatic diseases in Lebanon: a COPCORD study

“…The high prevalence of RA in Lebanon may be attributed to our rigorous sampling method, the use of laboratory and radiological tests to confirm RA cases, and the comprehensive definition of positive respondents. Moreover, the prevalence of Behcet’s disease was high with approximately 0.1% of the sample (85 in 100 000 inhabitants), a figure close to Turkey, 27 Druze and Arab communities in Israel, 28,29 but lower than that of other Arab countries 30,31 …”

Genotyping of geographically diverse Druze trios reveals substructure and a recent bottleneck

“…11 Moreover, there are multifactorial disorders that are more common in the Druze community than in any other Israeli ethnic group, primarily attributable to genetic factors: for example, Behcet disease was reported at a rate of 50-185:100 000 in the Druze population, compared with the often quoted rate of less than 1:100 000 individuals of other ethnicities. 12 A number of previous studies have investigated the genetic structure of the Druze. Shlush et al 13,14 used mitochondrial DNA and Y chromosome markers to find particularly high diversity of uniparental haplogroups in Galilee Druze.…”

Reconstructing Druze population history

“…making them attractive candidates for epidemiological studies. Although such inferences cannot be drawn based on a presumed social structure and geographical preference, genetic efforts targeting the Druze have identified several rare, mainly monogenic, recessive disorders like Behçet’s disease23 in several Druze individuals.…”