1、Behcets disease (BD) and tuberculosis,Introduction,where BD is endemic, the prevalence of tuberculosis is also relatively high.,Pathogenesis of BD,Micro-organisms Viruses: Herpes simplex virus, Hepatitis viruses, Human immunodeficiency virus, Parvovirus B19, Cytomegalovirus Bacteria: Streptococci: S
2、. sanguinis, S. aureus, S. pyogenes, S. haemolyticus, etc E. Coli,Heat Shock Protein (HSP),Common antigen significant homology between the human 60 kDa HSP and microbial 65 kDa HSP Mycobacterial HSP 65 stimulating T cells increasing VEGF,Close relationship between BD and TB in China,78例BD患者中48例合并明确结
3、核感染，抗结核治疗后BD症状减轻； 421例TB患者中72例符合BD; BD患者PPD强阳性但并无临床结核感染证据; 结核变态反应性白塞综合征? 参考文献： 1、白塞病与结核感染的相关性研究. 中华医院感染学杂志2001;11(6):434-5. 2、结核变态反应性疾病421例临床研究. 解放军医学杂志1991;16(6):435-7. 3、白塞病患者PPD试验强阳性的临床意义. 浙江医学2005;27(8):615-6. 4、结核性变态反应综合征. 中国临床医生 2006;34(3):33-4. 5、白塞病与结核感染的关系. 临床荟萃2009;24(19):1742-4.,PUMCH dat
4、a,BD: 112例 明确TB: 22例 （19.6%） 既往TB: 6例 活动性TB: 2例 BD发病后确诊:14例 可疑TB: 12例 （10.7%） 54例未作TB相关检查 （48.2%）,Pathergy Test,Non-specific hyperreactivity to minor trauma A creteria required for a diagnosis of BD Unknown cause Large variability between populations and within the same population with different inv
5、estigators genetic variables, disease related factors method and materials used to perform,Pathergy test and PPD: Controversy,False-positive of PPD in BD Cutis. 1980 May;25(5):529-30 PPD: not augmented in BD not affected by the pathergy phenomenon Rheumatology 2008;47:733734,9,Pathergy reaction,Stan
6、dard technique 20 gauge needle Papule or pustule in 48 hours Induration required More common in Middle East,PUMCH data,BD 共52例,Proposal,Aim 1. To investigate whether TB infection is one of the aetiologies of BD in China 2. To determine the effect of pathergy phenomenon on the response of BD patients to tuberculin test in China,Methods,Groups BD: 200 cases RA: 100 cases Healthy: 100 cases Pathergy test,Tuberculosis Symptoms History PPD and TB-Spot Chest X-ray,PPD and pathergy test were done at the same day and evaluated 48 h later, by two independent observers in a blinded manner.,
