Q J Med 2000; 93: 385
© 2000 Association of Physicians
Correspondence |
Behçet's syndrome
Department of Medicine, George Washington University, Washington DC
Sir,
I enjoyed reading the excellent review article on Behçet's disease.1 However, I was surprised that the authors did not mention cardiovascular involvement in Behçet's disease, although the subtitle of their article was ‘a multidisciplinary approach to clinical care’.
Cardiovascular involvement is common in Behçet's disease, especially mitral valve prolapse.2 There is a high incidence of mitral valve prolapse in patients with Behçet's disease, occurring in 50% of cases.3,4 The association of mitral valve prolapse and Behçet's disease was first reported from China.4,5 Shen et al.4 from Shanghai, China postulated that mitral valve prolapse may have been the result of structural damage and functional derangement caused by the underlying vasculitis of Behçet's disease.
I also would like to suggest that, in the Behçet's Syndrome Eye Disease Activity and Damage Form that followed their article as an Appendix, a notation be made about the presence or absence of mitral valve prolapse. This will not only alert the physician to examine the heart in every patient with Behçet's disease but also help to establish the incidence of mitral valve prolapse in Behçet's disease in the United Kingdom.
References
1.
Whallett AJ, Thurairajan G, Hamburger J, Palmer RG, Murray PI. Behçet's syndrome: a multidisciplinary approach to clinical care. Q J Med1999; 92:727–40.
2. Cheng TO. Behçet's disease. N Engl J Med2000;in press.
3. Morelli S, Perrone C, Ferrante L, Sgreccia A, Priori R, Voci P, Accorinti M, Pivetti-Pezzi P, Valesini G. Cardiac involvement in Behçet's disease. Cardiology1997; 88:513–17.[Web of Science][Medline]
4.
Shen L-L, Cui G-G, Liang R-L. Valve prolapse in Behçet's disease. Br Heart J1985; 54:100–1.
5. Cheng TO. Behçet's disease (‘Silk Route disease’) and mitral valve prolapse. Cardiology1998; 89:306.[Medline]
Directorate of Rheumatology, Solihull Hospital
Sir,
We would like to thank Professor Cheng for highlighting the importance of cardiovascular involvement in Behcet's syndrome. We recognize the importance of the high prevalence of mitral valve prolapse in patients with Behçet's. However at present we are not routinely performing transthoracic echocardiography on our patients unless they are symptomatic.
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