Jacobs Journal of Hematology Abnormalities of Fibrinolytic Parameters in Tunisian Patients with Behçet's Dis- ease. Correlations with the Clinical Presentation, the Activity, and the Severity of the Disease

Background: The thrombotic tendency in Behcet’s disease (BD) has been studied with variable results. We have studied d-dimer, tissue plasminogen activator (t-PA), and active Plasminogen Activator Inhibitor-1 (PAI-1) levels in Tunisian BD patients. We analyse hereby the correlations with the clinical presentation, the activity, and the severity of the disease. Patients and methods: A case-control prospective study of Tunisian BD patients was performed. Patients were classified as active and inactive, and evaluated according to Yazici severity score. D-dimer was determined by a quantitative assay test (VIDAS D-DIMER exclusion). T-PA and PAI-1 were determined by enzyme linked immunosorbent assay (ELISA). Results: Fifty- seven patients, 42 men (73%) and 15 women (27%), were studied; their mean age at the onset was 33 years. D-dimer was increased in 17 patients (31%) and normal in 39 (69%). D-dimer in BD patients was significantly higher than in healthy controls (p=0.033). There was a correlation between positive d-dimer and articular involvement (p=0.025). Positive d-dimer was significantly associated to the active phase of the disease (p=0.04). T-Pa levels were lower than in healthy controls (4.85 ± 7.36 vs 5.62 ± 8.49 ng/ml, p=NS). No significant differences were noted concerning t-PA levels among the clinical manifestations, the activity, or the severity of the disease. There was a significant correlation between ocular involvement and low level of PAI-1 (p=0.03). Conclusion: There are abnormalities in the fibrinolytic parameters in Tunisian BD patients. Due to the scarcity of publications, their implication in the pathogenesis of the disease as a cause or as a consequence is not clear.