THU0442 Is behcet’s syndrome getting milder? a retrospective analysis of initial presentation findings throughout 4 decades

Background There is some evidence that incident Behcet’s syndrome (BS) might be becoming less severe.1 Objectives We compared clinical findings at presentation of BS patients registered in a large, long standing dedicated multidisciplinary outpatient clinic at 4 time points during a 40 years period. Methods There were 4 groups. Group 1 included patients registered in 1979–1981, Group 2 those registered in 1990, Group 3 in 2000 and Group 4 in 2010. Only demographic and clinical findings at initial presentation were recorded. Results As shown in table 1, over 4 decades, male/female ratio decreases gradually. While mean age at presentation does not change, the median disease duration got shorter. Almost all clinical manifestations except genital ulcers and neurological involvement tended to decrease in frequency. This was also true when genders were separately analysed. Importantly the severity of vascular and eye disease decreased (table 1,2). The slope of vascular disease was more obvious. Conclusions Our observations support the notion that incident BS might be getting milder. There might be a list of explanations for this observation. 1. It might be a biological phenomenon due to changing environmental causes. In this line the significant decrease in papulopustular lesions could be due to a more sanitary environment while the rather unchanging frequency of neurologic involvement might be its possible independence from the environment. 2. It might be that the awareness of BS is increasing and we are recognising less severe cases. 3. Another explanation might be the more effective treatment these patients received before they were referred which was not specifically sought in this survey. Reference [1] Cingu AK, et al. Comparison of presenting features and three-year disease course in Turkish patients with Behcet uveitis who presented in the early 1990s and the early 2000s. Ocul Immunol Inflamm2012. Disclosure of Interest None declared