Predicting the Need for Additional Immunosuppressive Treatment in Pediatric Behçet’s Patients Pediatrik Behçet Hastalarında Ek İmmünsüpresif Tedavi Gereksiniminin Tahmin Edilmesi

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ŞENER S., Dalarslan S., BATU AKAL E. D.

Guncel Pediatri, cilt.21, sa.1, ss.43-51, 2023 (ESCI) identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 21 Sayı: 1
  • Basım Tarihi: 2023
  • Doi Numarası: 10.4274/jcp.2022.46693
  • Dergi Adı: Guncel Pediatri
  • Derginin Tarandığı İndeksler: Emerging Sources Citation Index (ESCI), Scopus, Academic Search Premier, CAB Abstracts, CINAHL, EMBASE, Veterinary Science Database
  • Sayfa Sayıları: ss.43-51
  • Anahtar Kelimeler: Behçet’s disease, immunosuppressive treatment, pediatric
  • Hacettepe Üniversitesi Adresli: Evet

Özet

Introduction: In our study, we evaluated the demographic and clinical characteristics of patients with pediatric Behçet’s disease (BD) and our treatment approaches in these patients. In addition, we aimed to determine the predictive factors in patients who need additional immunosuppressive therapy in addition to colchicine and short-term corticosteroid therapy in the treatment of BD. Materials and Methods: Pediatric patients followed up with BD between 2004-2022 were included in the study. The patients were divided into two groups: those receiving colchicine and/or short-term corticosteroids (group A) and those needing additional immunosuppressive treatments (group B). Results: Of a total of 103 patients, 57 (55.3%) were being followed up with a diagnosis of BD, and 46 (44.7%) with a diagnosis of incomplete BD. The most preferred drug in the treatment was colchicine (92.2%). Corticosteroids (55.3%) were often preferred with additional immunosuppressive agents in patients with major organ involvement. Biologic agents were used in 15 (14.6%) patients who were resistant to other immunosuppressive treatments. There were 56 patients in group A and 47 patients in group B. Ocular involvement and venous thrombosis were more common in group B. In addition, acute phase reactants and BHAAF scores at the diagnosis were higher in group B than in group A patients. As a result of multivariate analysis, ocular involvement [odds ratio (OR) 4,045, 95% CI 6,205-525,470; p=0.001], venous thrombosis (OR 2,497, 95% CI 3.048-48.358; p=0.001) and elevated acute phase reactants (OR 1.312, 95% CI 0.086-0.842; p=0.024) were identified as independent factors predicting the need for additional immunosuppressive therapy. Conclusion: Correct management of pediatric BD cases is very important in order to prevent complications that may develop. Our results showed that patients with ocular or vascular involvement, high acute phase reactants, and BHAAF scores may need additional immunosuppressive therapy at admission. Determining the factors that predict the need for treatment is important in making the appropriate treatment and follow-up plan for patients.