Behçet’s disease in Egypt: a multicenter nationwide study on 1526 adult patients and review of the literature

  • Tamer A. GheitaEmail author
  • Eiman Abd El-Latif
  • Iman I. El-Gazzar
  • Nermeen Samy
  • Nevin Hammam
  • Rasha A. Abdel Noor
  • Emad El-Shebeiny
  • Amany R. El-Najjar
  • Nahla N. Eesa
  • Mohamed N. Salem
  • Soha E. Ibrahim
  • Dina F. El-Essawi
  • Ahmed M. Elsaman
  • Hanan M. Fathi
  • Rehab A. Sallam
  • Rawhya R. El-Shereef
  • Mervat I. Abd-Elazeem
  • Emtethal A. Said
  • Noha M. Khalil
  • Dina Shahin
  • Hanan M. El-Saadany
  • Marwa S. ElKhalifa
  • Samah I. Nasef
  • Ahmed M. Abdalla
  • Nermeen Noshy
  • Rasha M. Fawzy
  • Ehab Saad
  • Abdel-Hafeez Moshrif
  • Amira T. El-Shanawany
  • Yousra H. Abdel-Fattah
  • Hossam M. Khalil
  • Egyptian College of Rheumatology-Behçet’s Disease Study Group (ECR-BDSG)
Original Article



The present work was conducted to estimate the prevalence of adult Behçet’s disease (BD) in adult Egyptian and to study the clinical pattern and influence of age at-onset and sex on disease phenotype. Also, we investigated the spectrum of presentation and frequencies along the north-to-south gradient of the country.

Patients and method

The population-based, multicenter, cross-sectional study included 1526 adult BD patients from 26 specialized Egyptian rheumatology centers. Demographic, clinical, and therapeutic data are assessed for all patients.


The mean age of patients was 35.7 ± 9.84 years, disease duration 6.58 ± 5.25 years, and age at onset 29.37 ± 8.6 years; 91 were juvenile-onset (JoBD). There were 1102 males and 424 females (M:F 2.6:1). Regarding co-morbidities, 19.92% were diabetic, and 26.05% were hypertensive. The mean body mass index was 27.57 ± 5.24 (43.1% overweight; 25.9% obese). The mean BD current activity form was 4.48 ± 4.28. Regarding the medications use, systemic steroid and colchicine were the most common drugs used (947 (90.2%) and 611 (82.7%), respectively). The overall estimated prevalence of BD in Egypt was 3.6/100,000 population being highest in the two main cities: Alexandria (15.27) and Cairo (8.72). Pathergy test was positive in 43.4%. 90.2% were receiving systemic steroids and 8.3%, biologics. Disease characteristics were comparable between JoBD and adult-onset BD cases. Central nervous system (CNS), deep venous thrombosis (DVT), and gastrointestinal (GIT) involvement were significantly higher in males (p = 0.01, p = 0.001, and p = 0.001 respectively) while joint affection (p = 0.001) and disease activity (p = 0.011) were increased in females.


This study provides current prevalence of BD in Egypt; 3.6/100,000 with no remarkable north-to-south gradient. The sex influences the disease phenotype with the CNS, DVT, and GIT involvement are higher in males, while the joint affection and disease activity were increased in females.

Key Points

The prevalence and phenotype of Behçet’s disease across Egypt is presented in a multicenter nationwide study.

The potential influence of the age at onset and sex on disease phenotype is highlightened.

A review of the literature worldwide is presented allowing comparisons with studies from other nations.


Age at onset Behçet’s disease Egypt Multicenter Prevalence Sex 


Compliance with ethical standards




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Copyright information

© International League of Associations for Rheumatology (ILAR) 2019

Authors and Affiliations

  • Tamer A. Gheita
    • 1
    Email author
  • Eiman Abd El-Latif
    • 2
  • Iman I. El-Gazzar
    • 1
  • Nermeen Samy
    • 3
  • Nevin Hammam
    • 4
    • 5
  • Rasha A. Abdel Noor
    • 6
  • Emad El-Shebeiny
    • 7
  • Amany R. El-Najjar
    • 8
  • Nahla N. Eesa
    • 1
  • Mohamed N. Salem
    • 9
  • Soha E. Ibrahim
    • 10
  • Dina F. El-Essawi
    • 11
  • Ahmed M. Elsaman
    • 12
  • Hanan M. Fathi
    • 13
  • Rehab A. Sallam
    • 14
  • Rawhya R. El-Shereef
    • 15
  • Mervat I. Abd-Elazeem
    • 16
  • Emtethal A. Said
    • 17
  • Noha M. Khalil
    • 18
  • Dina Shahin
    • 19
  • Hanan M. El-Saadany
    • 20
  • Marwa S. ElKhalifa
    • 21
  • Samah I. Nasef
    • 22
  • Ahmed M. Abdalla
    • 23
    • 24
  • Nermeen Noshy
    • 3
  • Rasha M. Fawzy
    • 17
  • Ehab Saad
    • 25
  • Abdel-Hafeez Moshrif
    • 26
  • Amira T. El-Shanawany
    • 27
  • Yousra H. Abdel-Fattah
    • 28
  • Hossam M. Khalil
    • 29
  • Egyptian College of Rheumatology-Behçet’s Disease Study Group (ECR-BDSG)
  1. 1.Rheumatology Department, Faculty of MedicineCairo UniversityCairoEgypt
  2. 2.Ophthalmology Department, Faculty of MedicineAlexandria UniversityAlexandriaEgypt
  3. 3.Internal Medicine Department, Rheumatology Unit, Faculty of MedicineAin-Shams UniversityCairoEgypt
  4. 4.Rheumatology Department, Faculty of MedicineAssuit UniversityAssuitEgypt
  5. 5.Faculty of Medicine and DentistryUniversity of AlbertaEdmontonCanada
  6. 6.Internal Medicine Department, Rheumatology UnitTanta UniversityTantaEgypt
  7. 7.Internal Medicine Department, Rheumatology UnitMenoufia UniversityShebeen El-KomEgypt
  8. 8.Rheumatology Department, Faculty of MedicineZagazig UniversityZagazigEgypt
  9. 9.Internal Medicine Department, Rheumatology Unit, Faculty of MedicineBeni-Suef UniversityBeni-SuefEgypt
  10. 10.Rheumatology Department, Faculty of MedicineAin Shams UniversityCairoEgypt
  11. 11.Internal Medicine Department, Rheumatology Unit (NCRRT)Atomic Energy Authority (AEA)CairoEgypt
  12. 12.Rheumatology Department, Faculty of MedicineSohag UniversitySohagEgypt
  13. 13.Rheumatology Department, Faculty of MedicineFayoum UniversityFayoumEgypt
  14. 14.Rheumatology Department, Faculty of MedicineMansoura UniversityMansouraEgypt
  15. 15.Rheumatology Department, Faculty of MedicineMinia UniversityMiniaEgypt
  16. 16.Rheumatology Department, Faculty of MedicineBeni-Suef UniversityBeni-SuefEgypt
  17. 17.Rheumatology Department, Faculty of MedicineBenha UniversityBenhaEgypt
  18. 18.Internal Medicine Department, Rheumatology Unit, Faculty of MedicineCairo UniversityCairoEgypt
  19. 19.Internal Medicine Department, Rheumatology Unit, Faculty of MedicineMansoura UniversityMansouraEgypt
  20. 20.Rheumatology Department, Faculty of MedicineTanta UniversityTantaEgypt
  21. 21.Internal Medicine Department, Rheumatology Unit, Faculty of MedicineAlexandria UniversityAlexandriaEgypt
  22. 22.Rheumatology Department, Faculty of MedicineSuez-Canal UniversityIsmailiaEgypt
  23. 23.Rheumatology Department, Faculty of MedicineAswan UniversityAswanEgypt
  24. 24.Internal Medicine Department III, Division of RheumatologyMedical University of ViennaViennaAustria
  25. 25.Rheumatology Department, Faculty of MedicineSouth Valley UniversityQenaEgypt
  26. 26.Rheumatology Department, Faculty of MedicineAl-Azhar UniversityAssuitEgypt
  27. 27.Rheumatology Department, Faculty of MedicineMenoufia UniversityShebeen El-KomEgypt
  28. 28.Rheumatology Department, Faculty of MedicineAlexandria UniversityAlexandriaEgypt
  29. 29.Ophthalmology Department, Faculty of MedicineBeni-Suef UniversityBeni-SuefEgypt

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