Objective. Our aim was to evaluate the significance of homocysteine (Hcy) in Behcet's disease (BD) and the association of elevated Hcy levels associated with the indices of inflammation in BD. Methods. Untreated 70 patients with BD and 33 healthy individuals were included into the study. Hcy, tumor necrosis alpha (TNF-α), C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR) were evaluated with respect to activity and specific individual clinical manifestations of the disease. Results. Hcy levels were found significantly elevated in active BD when compared to inactive BD and healthy controls. Hcy levels were found to have high correlation with the number of active clinical manifestations increased. A significant positive correlation was found between serum Hcy and TNF-α levels, CRP, and ESR. Hcy was found to be the best predictor of TNF-α among other parameters. Conclusion. Hcy may involve in the pathogenesis of BD by inducing inflammation.
Objective:To evaluate the association of dry eye and vitiligo diseases with objective parameters and a questionnaire.Methods:The study was conducted in 30 vitiligo patients and 31 patients with non-complicated refractory complaints. All the patients underwent complete ophthalmologic examinations including fluorescein break-up time (FBU), corneal fluorescein staining (CFS) and Schirmer test-I. The dry eye status was evaluated by means of Ocular Surface Disease Index (OSDI).Results:The groups were similar regarding the age and gender distribution. The vitiligo group had higher OSDI scores (26.1±15.9 vs 14.7±5.4, t-test, p<0.001), shorter FBU (7.8±2.9 vs 9.8±2.2, Mann Whitney U test, p=0.005) and higher CFS positivity (18/30 vs 3/31, chi-square test, p<0.001) than control group. The groups were similar regarding the Meibomian Gland Dysfunction (MGD) and Schirmer test results. Fourteen (46.7%) of vitiligo patients had periocular involvement. The analysis within vitiligo patients revealed that FBU and Schirmer test were shorter in patients with periocular involvement, the OSDI scores and MGD status were similar.Conclusion:Our study suggest a possible association of dry eye and vitiligo diseases. The diagnostic tools for dry eye disease are in good correlation with each other. The OSDI questionnaire seems practical for both diagnostic purposes and follow-up.
As hyperhomocysteinemia can be treated by selected vitamin supplementation even in patients with normal serum vitamin concentrations, ulcer formation might be prevented by lowering Hcy in the clinical stage of stasis dermatitis.
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