Fever in Behçet's syndrome

Fever is taken to be rare in Behçet's syndrome (BS) and when present it is usually considered to be associated with vascular disease. The aim of this study was to formally investigate the presence of fever as a clinical feature in BS patients and suitable controls. The study consisted of 2 parts. In the first part, 500 patients with BS, 94 with familial Mediterranean fever (FMF), 100 with ankylosing spondylitis (AS), and 72 with systemic lupus erythematosus (SLE) along with 100 healthy controls (HC) were surveyed with the help of a questionnaire for the history of periodic fever episodes. In the second part, body temperature was measured in 98 newly diagnosed BS patients having at least one active BS lesion and 61 HC. Temperature was measured 3 times and the highest reading was used in the analyses. First part: history of fever episodes was present in 22% patients with BS, 87% with FMF, 33% with SLE and 8% with AS. None of the HC recalled a fever episode. Patients with BS who reported fever episodes were more likely to have major organ involvement such as vascular, neurological or joint involvement. Second part: The mean body temperature reading was similar (albeit statistically different) among patients with BS (36.72±0.42ºC) compared to that of the HC (36.56± 0.27ºC) (p=0.004). In this study, 22% of patients with BS reported a history of fever episodes. As previously reported, fever attacks seemed to be associated strongly with vascular, neurological or joint involvement. The increase in temperature accompanying active BS lesions was modest even when the highest values were considered.