Rheumatol Int. 2026 Oct 31;46(11):298. doi: 10.1007/s00296-026-06338-3.
ABSTRACT
Behçet's syndrome is a heterogeneous disease with diverse patterns of organ involvement. We aimed to identify clinical subgroups using latent class analysis and evaluate clinical characteristics and treatment patterns across the identified subgroups and sex. We retrospectively evaluated 136 patients fulfilling the International Criteria for Behçet's Disease. Latent class analysis (LCA) based on six clinical indicators was used to identify clinical subgroups. Clinical manifestations, major organ involvement, and current treatments were compared between the identified latent classes and by sex. Major organ involvement occurred in 79 patients (58.1%). Among the standard LCA models, the two-class solution had the lowest BIC. Class 1 (40.4%) was characterized by absence of pathergy positivity and a very low probability of papulopustular lesions (1.3%), but a higher probability of ocular involvement (60.0%). Class 2 (59.6%) showed high probabilities of pathergy positivity (90.7%) and papulopustular lesions (57.7%). Major organ involvement was more frequent in Class 1 than in Class 2 (70.9% vs. 49.4%, p = 0.020). Male patients had significantly higher rates of ocular (52.7% vs. 35.5%, p = 0.044), vascular (28.4% vs. 8.1%, p = 0.003), and major organ involvement (73.0% vs. 40.3%, p < 0.001), as well as current anti-TNF therapy (23.0% vs. 8.1%, p = 0.019), than female patients. Patients with major organ involvement had significantly lower rates of genital ulcer history (51.9% vs. 84.2%, p < 0.001), pathergy positivity (45.6% vs. 70.2%, p = 0.004), and joint involvement (11.4% vs. 28.1%, p = 0.013). The BIC-selected solution identified two main patient groups, but the class structure was highly sensitive to indicator selection. Overall, our findings support exploratory clinical patterns rather than fixed Behçet phenotypes, with major organ involvement being significantly more frequent among men.
PMID:42965659 | DOI:10.1007/s00296-026-06338-3