Serum Amyloid-A in Behçet’s Disease: Relation to Clinical Manifestations and Disease Activity

Abstract

Background: Behcet's disease (BD) is an autoimmune systemic vasculitis with an unknown origin. Recent discoveries have proven the essential role of Serum Amyloid A (SAA) in the pathophysiology of inflammatory rheumatic illnesses, including its involvement in the activation of the inflammasome cascade and the recruitment of interleukin 17-producing T helper cells. Aim of the work:This study aimed to measure the level of SAA in Behçet's disease and to examine the relation of SAA levels with disease activity and different organ involvement. Patients and Methods: This case-control research was done on 30 Behcets' cases which were subjected to history taking, full clinical examination, and assessment of disease activity by Behcet Disease Current Activity Form (BDCAF). Investigation in the form of CBC, ESR, CRP, and SAA were assessed. Results: Serum amyloid-A level was significantly greater in BD cases when contrasted to controls (P<0.001). Higher SAA was significantly related to the existence of oral ulcers, genital ulcers (P=0.041), eye involvement (P=0.005), and musculoskeletal manifestations (P=0.049). Skin manifestations, neurologic and large vessel involvements were not associated with SAA levels (P=0.948, P=0.077, and P=0.198 respectively). Lower SAA was significantly associated with those who received biologic therapy (P=0.045). Serum amyloid-A levels revealed significant positive relationships with disease activity (P<0.05) and higher SAA was considered a risk predictor for BD susceptibility (P=0.002), OR 1.156. Conclusion: Serum amyloid-A would be a predictor for BD susceptibility and activity. SAA levels are associated with ocular manifestations and could be a predictor of eye involvement.