Behçet's disease screening

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Hamid Qazi, MD, BSc [2] Dheeraj Makkar, M.D.[3]

Overview

Screening for Behçet’s syndrome relies on clinical vigilance rather than population-based testing. Patients with recurrent oral ulcers and multisystem involvement should be evaluated with structured classification criteria, supplemented by imaging and targeted investigations. Genetic testing (HLA-B*51) or biomarkers are not useful as standalone screening tools, but recognition of characteristic patterns enables earlier diagnosis and management.

Screening

There is insufficient evidence to recommend routine screening for Behçet disease.


  • Lack of Specific Biomarkers

There are no definitive biologic or histologic tests that can be used as universal screening tools for Behçet’s syndrome.

HLA-B*51 is more common in patients, but its high prevalence in the general population makes it unsuitable for screening purposes .

  • Clinical-Based Screening Approach

Because of its heterogeneous and multisystem presentation, early recognition depends on careful clinical observation.

Recurrent oral ulceration is the hallmark and often the first sign; patients with persistent oral ulcers plus genital, ocular, vascular, or neurologic symptoms should be screened clinically for Behçet’s syndrome.

Certain features such as genital scarring, specific ocular findings (uveitis with hypopyon, retinal vasculitis), and vascular thrombosis adherent to vessel walls are strong clues for diagnosis .

  • Classification Criteria as Screening Tools

The 1990 ISG criteria and the 2014 ICBD criteria are the main structured frameworks used to identify and classify suspected cases.

ISG (1990): requires recurrent oral ulcers plus two additional manifestations.

ICBD (2014): uses a weighted point system (≥4 points required).

In practice, these serve as screening frameworks in clinical and research settings rather than diagnostic tests .

  • Imaging and Specialist Evaluation

When systemic involvement is suspected, targeted imaging and specialist input (e.g., ophthalmology for uveitis, Doppler/CT angiography for vascular disease, MRI for CNS involvement) are essential to screen for organ-specific manifestations earl

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