In this multicenter study, we aimed to describe the demographic and clinical features along with severity in juvenile- versus adult-onset BD.
Patients with initial symptoms at age 16 years or younger were considered as having juvenile-onset BD. In all, 83 patients with juvenile-onset BD (38 male and 45 female; mean age 19.6 ± 7.6 years) and 536 with adult-onset (>16 years) BD (293 male and 243 female; mean age 39.2 ± 10.1 years) who fulfilled the classification criteria of the International Study Group for BD were involved in the study.
Familial cases were more frequent in juvenile-onset compared with adult-onset BD (19 % vs 10.3 % ; P = .017). The mean age of disease onset was 12.29 ± 3.54 years in juvenile-onset BD and 31.66 ± 8.71 years in adult-onset BD. Mucocutaneous lesions and articular symptoms were the most commonly observed manifestations in both groups. The frequency of disease manifestations was not different between juvenile- and adult-onset BD, except neurologic and gastrointestinal involvement, which were higher in juvenile-onset BD than adult-onset BD (P = .027 and P = .024, respectively). Oral ulcer was the most common onset manifestation of both juvenile-onset (86.74 % ) and adult-onset (89.55 % ) BD. The frequencies of onset manifestations of BD were similar, except genital ulcer, which was higher in adult-onset BD (P = .025).
Our study consisted of patients with BD mainly applying to dermatology and venerology departments. Therefore, it can be speculated that this study includes rather a milder spectrum of the disease.
Although the clinical spectrum of juvenile-onset BD seems to be similar to adult-onset BD, the frequency of severe organ involvement was higher. Because of the higher prevalence of familial cases in juvenile-onset BD, it can be speculated that genetic factors may favor early expression of the disease with severe organ involvement.