S-64
Division of Rheumatology, Department of
Medicine, Cerrahpasa Medical Faculty,
University of Istanbul, Istanbul, Turkey.
Emire Seyahi, MD, Professor of Medicine
Huseyin Karaaslan, MD, Fellow
Serdal Ugurlu, MD, Associate Professor
Hasan Yazici, MD, Professor of Medicine
Please address correspondence to:
Emire Seyahi, MD,
Halaskargazi Cad. no: 209-211,
Huzur ap. D: 2, Sisli,
34360 Istanbul, Turkey.
E-mail: eseyahi@yahoo.com
Received on March 22, 2013; accepted in
revised form on July 5, 2013.
Clin Exp Rheumatol 2013; 31 (Suppl. 77):
S64-S67.
© Copyright CliniCal and
ExpErimEntal rhEumatology 2013.
Key words: fever, Behçet’s syndrome
Competing interests: none declared.
ABSTRACT
Objectives. Fever is taken to be rare
in Behçet’s syndrome (BS) and when
present it is usually considered to be
associated with vascular disease. The
aim of this study was to formally inves-
tigate the presence of fever as a clini-
cal feature in BS patients and suitable
controls.
Methods. The study consisted of 2
parts. In the frst part, 500 patients with
BS, 94 with familial Mediterranean fe-
ver (FMF), 100 with ankylosing spon-
dylitis (AS), and 72 with systemic lupus
erythematosus (SLE) along with 100
healthy controls (HC) were surveyed
with the help of a questionnaire for
the history of periodic fever episodes.
In the second part, body temperature
was measured in 98 newly diagnosed
BS patients having at least one active
BS lesion and 61 HC. Temperature was
measured 3 times and the highest read-
ing was used in the analyses.
Results. First part: history of fever
episodes was present in 22% patients
with BS, 87% with FMF, 33% with SLE
and 8% with AS. None of the HC re-
called a fever episode. Patients with BS
who reported fever episodes were more
likely to have major organ involvement
such as vascular, neurological or joint
involvement.
Second part: The mean body tempera-
ture reading was similar (albeit statis-
tically different) among patients with
BS (36.72±0.42ºC) compared to that of
the HC (36.56± 0.27ºC) (p=0.004).
Conclusion. In this study, 22% of pa-
tients with BS reported a history of fe-
ver episodes. As previously reported,
fever attacks seemed to be associated
strongly with vascular, neurological or
joint involvement. The increase in tem-
perature accompanying active BS le-
sions was modest even when the high-
est values were considered.
Introduction
Fever is taken to be rare in Behçet’s
syndrome (1-4). However, there are
several case reports describing fever
especially among patients with vas-
cular or neurological involvement (5-
10). Recently, we have reported fever
among our patients with pulmonary
vascular disease (11). Finally, there are
even case reports identifying BS as a
rare cause of fever of unknown origin
(FUO) (12-15).
In the current work we aimed to re-
assess the frequency of fever in BS, as
we believe for the frst time, in a formal
protocol, with suitable control groups.
We also measured body temperature in
newly diagnosed BS patients with ac-
tive disease not using immunosuppres-
sives or corticosteroids to assess wheth-
er active lesions of BS are accompanied
by an increase in temperature.
Patients and methods
The study consisted of 2 parts: In the
frst part, a history of recurrent fever
episodes was surveyed with the help of
a questionnaire in consecutive BS, fa-
milial Mediterranean fever (FMF), sys-
temic lupus erythematosus (SLE) and
ankylosing spondylitis (AS) patients
along with healthy controls (HC). BS,
FMF, SLE and AS patients were regu-
lar attendees of either the dedicated BS
or the rheumatology outpatient clinic
at Cerrahpasa Medical Faculty of Uni-
versity of Istanbul. The HC were appar-
ently healthy volunteers chosen among
the hospital staff. Answers to ‘have
you ever had recurrent fever episodes?’
question were classifed as ‘yes’, ‘no’
or ‘do not know’. For the sake of sim-
plicity, the responses of those who were
unable to remember whether they had
had fever were considered negative.
Episodes of recurrent fever were identi-
fed as fever attacks a) recurring at least
3 times a year, b) present in any given
time interval in the past and c) not as-
sociated with a specifc infection. Ad-
ditionally, symptoms present during fe-
ver episodes were recorded among BS
patients. Clinical characteristics of BS
patients were obtained from the charts.
Fever in Behçet’s syndrome
E. Seyahi, H. Karaaslan, S. Ugurlu, H. Yazici