Anticoagulant and Fibrinolytic Disorders in Patients with Behcet's Disease and Recurrent Aphthous Ulcer

Behcet's disease (BD) is a chronic multisystemic inflammatory disorder characterized by recurrent oral and genital aphthous ulcers, uveitis and skin lesions. Recurrent aphthous ulcer (RAU) is the most prevalent oral mucosal disease in humans. The pathogenesis and thrombopoiesis of BD and RAU have not been fully clarified. To reveal the haemostatic dysfunctions in the patients with BD and RAU, we evaluated the levels of coagulant, anticoagulant and fibrinolytic parameters in these patients. Factor VIII clotting activity (FVIII:c), protein C antigen (PC:Ag), total protein S antigen (TPS:Ag), tissue-type plasminogen activator antigen (t-PA:Ag), plasminogen activator inhibitor-1 antigen (PAI-1:Ag) and D-dimer were detected in 24 BD, 58 RAU patients and 50 controls. Results showed that levels of PC:Ag, TPS:Ag, PAI-1:Ag and D-dimer were significantly elevated in both BD and RAU patients compared with controls (P < 0.01). PAI-1:Ag was even higher in BD patients than in RAU patients (74.99 +/- 12.28 vs. 69.57 +/- 13.11, P < 0.05), whereas the level of t-PA:Ag was significantly reduced in patients with BD and RAU (P < 0.01). In patients with RAU, PC:Ag was lower in major aphthous ulcer (MjAU) group than in minor aphthous ulcer (MiAU) group (P < 0.05). The expression of FVIII:c was significantly elevated in MiAU patients compared with controls (P < 0.01), while no difference was observed between MjAU patients and controls (P > 0.05). Our studies showed that there were anticoagulant and fibrinolytic disorders in BD patients, which may be responsible for diminished fibrinolysis in BD. Some haemostatic parameters may be correlated with the severity of RAU.