498-500
Clinical rheumatology, 1990, 9, N" 4
Antibodies to herpes simplex virus in patients with Behget's disease M. HAMZA, K. AYED* *
M.
ELLEUCH,
A.
SLIM*,
K.
HAMZAOUI**,
Service de R h u m a t o l o g i e , H 6 p i t a l la R a b t a , T u n i s ; * L a b o r a t o i r e d ' I m m u n o l o g i e , H 6 p i t a l C h a r l e s Nicolle, T u n i s ; * * L a b o r a t o i r e de Bactdriologie et de Virologie, H 6 p i t a l C h a r l e s Nicolle, T u n i s - Tunisie. Key w o r d s : H e r p e s Simplex, Behget's Disease. INTRODUCTION Infectious agents had been incriminated in the pathogenesis of Behcet's disease (BD) especially herpes simplex virus type 1 (HVS-1). This hypothesis is supported by many findings. Hybridization studies showed complementary RNA to HSV-1 DNA in the mononuclear cells from patients with BD (1). The phytohaemagglutinin-transformed lymphocytes from patients with BD were unable to support the growth of HSV-1 (2). A proliferative response of HSV-l-stimulated CD4 cells from patients with BD was observed (3). Increased IgG anti HSV-1 antibodies were found in sera and the PEG material from patients with BD in England (4). In this work we study the levels of HSV-1 serum antibodies in Tunisian patients. M A T E R I A L AND M E T H O D Thirty patients (28 men and 2 women) with a mean age of 36 years +_ 8,8 were studied. Disease duration was 1 to 12 years with a mean of 2 _ 4.28. Clinical manifestations were as follows : buccal aphthosis (30 cases), genital aphthosis (23 cases), necrotic pseudofolliculitis (20 cases) dermohypodermal le-
Received: 5 D e c e m b e r 1989 Revision-accepted: 24 April 1990 Correspondence to: Dr. M ' H A M E D H A M Z A , BP 45 E1 Menzeh 1014, Tunisia.
sions (7 cases) positive pathergic test (14 cases), uveitis (14 cases) venous thrombosis (11 cases), arthritis (10 cases), central system nervous involvement (3 cases) and pulmonary manifestations (1 case). All patients had buccal aphthosis associated with at least 2 of the following criteria; genital aphthosis, cutaneous lesions, uveitis and positive pathergy test which was defined as a skin hyperreactivity associated with erythema, papule and pustule to sterile needle prick read at 48 hours. According to the classification of Lehner, there were 8 with mucocutaneous type, 7 arthritic, 12 ocular, and 3 with neurological type. The mucocutaneous type involved oral and genital skin manifestations. The arthritic type associated joint involvement with some or all of the mucocutaneous manifestations and the neurological type showed brain involvement with some or all of the lesions found in the mucocutaneous and arthritic types. In the ocular type, uveitis was added to some or all of the mucocutaneous, arthritic and neurological manifestations. Fifteen had active disease and 15 inactive disease. Patients were treated with chlorambucil (7 cases), colchicine and prednisone (12 cases), colchicine alone (5 cases) and thalidomide (6 cases). Control studies were carried out in 20 healthy subjects (5 men and 15 women, mean age 36) with no history of clinical herpes disease. The control group was matched with Behget patients according to age but not sex. This sex difference is not to be considered,
Antibodies to herpes simplex virus in patients with Behfet's disease
499
R E S U L T S AND DISCUSSION IgM antibodies were not found in patients or in controls. Among the patients we have observed a wide range in the titres of IgG antibodies to HSV-1 (Fig. 1). Statistical analysis showed that the antibodies titres were significantly higher (p
Clinical rheumatology, 1990, 9, N" 4
Antibodies to herpes simplex virus in patients with Behget's disease M. HAMZA, K. AYED* *
M.
ELLEUCH,
A.
SLIM*,
K.
HAMZAOUI**,
Service de R h u m a t o l o g i e , H 6 p i t a l la R a b t a , T u n i s ; * L a b o r a t o i r e d ' I m m u n o l o g i e , H 6 p i t a l C h a r l e s Nicolle, T u n i s ; * * L a b o r a t o i r e de Bactdriologie et de Virologie, H 6 p i t a l C h a r l e s Nicolle, T u n i s - Tunisie. Key w o r d s : H e r p e s Simplex, Behget's Disease. INTRODUCTION Infectious agents had been incriminated in the pathogenesis of Behcet's disease (BD) especially herpes simplex virus type 1 (HVS-1). This hypothesis is supported by many findings. Hybridization studies showed complementary RNA to HSV-1 DNA in the mononuclear cells from patients with BD (1). The phytohaemagglutinin-transformed lymphocytes from patients with BD were unable to support the growth of HSV-1 (2). A proliferative response of HSV-l-stimulated CD4 cells from patients with BD was observed (3). Increased IgG anti HSV-1 antibodies were found in sera and the PEG material from patients with BD in England (4). In this work we study the levels of HSV-1 serum antibodies in Tunisian patients. M A T E R I A L AND M E T H O D Thirty patients (28 men and 2 women) with a mean age of 36 years +_ 8,8 were studied. Disease duration was 1 to 12 years with a mean of 2 _ 4.28. Clinical manifestations were as follows : buccal aphthosis (30 cases), genital aphthosis (23 cases), necrotic pseudofolliculitis (20 cases) dermohypodermal le-
Received: 5 D e c e m b e r 1989 Revision-accepted: 24 April 1990 Correspondence to: Dr. M ' H A M E D H A M Z A , BP 45 E1 Menzeh 1014, Tunisia.
sions (7 cases) positive pathergic test (14 cases), uveitis (14 cases) venous thrombosis (11 cases), arthritis (10 cases), central system nervous involvement (3 cases) and pulmonary manifestations (1 case). All patients had buccal aphthosis associated with at least 2 of the following criteria; genital aphthosis, cutaneous lesions, uveitis and positive pathergy test which was defined as a skin hyperreactivity associated with erythema, papule and pustule to sterile needle prick read at 48 hours. According to the classification of Lehner, there were 8 with mucocutaneous type, 7 arthritic, 12 ocular, and 3 with neurological type. The mucocutaneous type involved oral and genital skin manifestations. The arthritic type associated joint involvement with some or all of the mucocutaneous manifestations and the neurological type showed brain involvement with some or all of the lesions found in the mucocutaneous and arthritic types. In the ocular type, uveitis was added to some or all of the mucocutaneous, arthritic and neurological manifestations. Fifteen had active disease and 15 inactive disease. Patients were treated with chlorambucil (7 cases), colchicine and prednisone (12 cases), colchicine alone (5 cases) and thalidomide (6 cases). Control studies were carried out in 20 healthy subjects (5 men and 15 women, mean age 36) with no history of clinical herpes disease. The control group was matched with Behget patients according to age but not sex. This sex difference is not to be considered,
Antibodies to herpes simplex virus in patients with Behfet's disease
499
R E S U L T S AND DISCUSSION IgM antibodies were not found in patients or in controls. Among the patients we have observed a wide range in the titres of IgG antibodies to HSV-1 (Fig. 1). Statistical analysis showed that the antibodies titres were significantly higher (p
