Dear Sirs,

We very much appreciated the brief report by Bilge et al. recently published in Clinical Rheumatology [1] about the utility of rotational thromboelastometry (ROTEM) in Behçet's disease (BD). Bilge et al. reported a significant increase in maximum clot firmness (MCF) in a cohort of patients with BD, which may indicate a prothrombotic state in this disease. This report is in line with a study we recently published [2] highlighting the usefulness of ROTEM and of the calibrated automated thrombogram for studying the hypercoagulable state in BD patients.

In our study, we found an increase in the MCF by the INTEM test in a group of BD patients with various degrees of disease activity. Interestingly, INTEM-MCF significantly correlates with disease activity and with plasma levels of E-selectin, a marker of endothelial damage/activation.

We also observed a significant reduction in the CFT by the INTEM test in samples from BD. This last observation does not match with Bilge's report, and the difference might lie in the fact that none of their patients were in the active phase of the disease during the study.

We recognize the high scientific value of the article by Bilge et al., and it strengthens our assumption that the ROTEM test may be a useful tool for monitoring the therapeutic response and disease progression in BD patients.