Wednesday, February 14, 2007

Diagnosing Behcet's -- Part 1 (Lab tests)

Over the next few days, I'm going to take a look at the different types of information that doctors use in diagnosing a case of Behcet's disease. As a reminder, there are no specific blood test results, lab results or biopsy results that will tell a doctor that you have Behcet's. Each of the posts that I make this week will only provide a small piece of the puzzle. You need a doctor who's experienced in Behcet's diagnosis and treatment to pull all the pieces together. The American Behcet's Disease Association maintains a Doctors' Registry on their website that lists patient-recommended doctors across the U.S. You can access the list here.

The following information is from Essential Guide to Behcet's Disease (c 2003 J Zeis). References appear in parentheses and can be supplied separately.

\\ Even though there are no tests that will definitely diagnose
a case of Behçet's, certain test results can appear more
frequently in BD patients. However, NONE of the results
listed below are specifically required for diagnosis.
For example :

1) neutrophil and platelet counts may be increased(80)
2) C-reactive protein (CRP) and ESR may be elevated, and
may correlate w/disease activity(81) [O'Duffy (1997) states
that it is possible to have active disease (i.e.uveitis) when
serum and ESR levels are normal(117)]
3) ANCA, ANA, and antiphospholipid antibodies are usually
4) lesions may show a mixed leukocytic infiltration of
neutrophils and mononuclear cells into tissues(80), evidence
of cutaneous leukocytoclastic vasculitis(98) or frank
necrotizing vasculitis(117)
5) serum immunoglobulins, especially IgA, may be elevated
(82). IgA, IgG and IgM levels may show nonspecific elevations
in active neuro-Behçet's.(117)
6) circulating immune complexes (CIC) may be elevated,
and may be related to disease activity(85)
7) C3 levels in the cerebrospinal fluid tend to be elevated(83)
8) C9 serum levels may also be elevated(83)
9) clotting time, bleeding time, prothrombin time, and partial
thromboplastin time tend to be normal(84)
10) fibrinogen levels may be elevated, and may parallel
disease activity(84)
11) IL-8 serum levels may be increased in patients with
active oral and neurological symptoms(86)
12) serum amyloid A, and beta-2 microglobulin levels may
be elevated, and may closely parallel disease activity
(Aygunduz et al, 2000, found these tests to be even more
sensitive than ESR and CRP levels) (108)
13) rheumatoid factor (RF) may be present, regardless
of disease activity(88,89) \\

Immunoglobulin E: a new diagnostic clue
for Behcet's disease? IgE and Behcet's disease.

The FULL-TEXT PDF of this article is
available online.

Clin Rheumatol. 2007 Jan;26(1):81-3.
Onat AM, Buyukhatipoglu H, Yilmaz M, Geyik R,
Celik A, Ozturk MA.
Department of Rheumatology, School of Medicine,
Gaziantep University, Gaziantep, Turkey.


  1. Oh I wish I could see this. I was told IgE should be under 100 and mine is over 800. Wondering what all that means.

  2. Hi teacherswife,
    Please write to me privately: joanne at behcetsdisease dot com
    I can email a copy of the article to you.