Is Fatigue a Symptom of Behçet's Disease?
Yes, fatigue is a well-recognized and common symptom of Behçet's disease, occurring in a significant proportion of patients and correlating with disease activity, though it can persist even during inactive disease phases.
Prevalence and Clinical Significance
- Fatigue is highly prevalent in Behçet's disease patients, with research demonstrating significantly higher fatigue severity scores compared to healthy controls 1, 2, 3
- The symptom affects quality of life substantially and occurs across all types of organ involvement (ocular, vascular, joint, and mucocutaneous manifestations) with similar severity 1
- Fatigue severity is similar between male and female patients with Behçet's disease 1
Relationship to Disease Activity
- Patients with active Behçet's disease experience significantly more severe fatigue compared to those with inactive disease 2, 3
- Fatigue correlates positively with disease activity measures including the Behçet Syndrome Activity Scale (BSAS) and physician's global assessment 2, 3
- However, fatigue can persist even when disease is clinically inactive, making it an important consideration throughout the disease course 4
Associated Factors
The severity of fatigue in Behçet's disease is significantly associated with:
- Depression and anxiety, which show strong positive correlations with fatigue scores 2, 3
- Physical dysfunction and disability, as measured by the Health Assessment Questionnaire 2
- Reduced quality of life, with negative correlations between fatigue and both physical and mental components of quality of life measures 2, 3
- In regression analyses, depression, anxiety, and physical dysfunction were independent predictors of fatigue severity after adjusting for other variables 2
Clinical Implications
- Fatigue should be systematically assessed in all Behçet's disease patients as it represents a candidate outcome measure for clinical trials and disease impact assessment 1
- The multidimensional nature of fatigue in Behçet's disease requires evaluation of concurrent psychological distress, sleep disturbance, and functional impairment 2, 3
- Treating active inflammation may reduce fatigue severity, as disease activity correlates with fatigue levels 2, 3
Important Caveats
- While the 2010 ACCF/AHA guidelines describe the cardinal manifestations of Behçet's disease (oral ulceration, genital ulceration, uveitis, and skin lesions), they do not specifically list fatigue among the diagnostic criteria 5
- Fatigue is not part of the formal diagnostic criteria established by the International Group for Behçet's disease, but represents an important symptomatic manifestation affecting patient quality of life 5
- The natural course of Behçet's disease typically shows decreasing frequency and severity of inflammatory exacerbations over time, which may influence fatigue patterns 4