From the Research
Initial screening bloodwork for Behçet's disease typically includes complete blood count (CBC), erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), comprehensive metabolic panel, and HLA-B51 genetic testing. These tests help assess inflammation and rule out other conditions with similar presentations. CBC may show anemia of chronic disease or leukocytosis, while elevated ESR and CRP indicate systemic inflammation 1. Liver and kidney function tests are important to establish baseline organ function before starting medications and to exclude other diseases. HLA-B51 positivity, while not diagnostic, is found in 50-70% of Behçet's patients and supports the diagnosis when clinical features are present. Additional tests might include antinuclear antibody (ANA), rheumatoid factor, and antiphospholipid antibodies to exclude other autoimmune conditions. Pathergy testing (skin prick test) may also be performed alongside bloodwork. Some studies suggest that markers of endothelial dysfunction, such as homocysteine, asymmetric dimethylarginine (ADMA), and high-sensitivity C-reactive protein (hsCRP), may be useful in assessing disease activity in Behçet's disease 2. However, the most recent and highest quality study, published in 2023, does not specifically address the initial screening bloodwork for Behçet's disease 3. Other studies have investigated the use of systemic immune-inflammation index (SII) and platelet-to-lymphocyte ratio (PLR) and neutrophil-to-lymphocyte ratio (NLR) in assessing disease activity in Behçet's disease, but these are not typically included in initial screening bloodwork 4, 5. Key points to consider when ordering initial screening bloodwork for Behçet's disease include:
- Assessing inflammation with ESR and CRP
- Evaluating liver and kidney function with comprehensive metabolic panel
- Testing for HLA-B51 genetic marker
- Considering additional tests to exclude other autoimmune conditions
- Using clinical features and medical history to guide diagnosis and treatment.