Clinical course of ocular Behcet's disease in siblings

Purpose: Familial occurrence has been reported in approximately 8% of Turkish patients with Behcet's disease. Our aim was to compare the clinical course of ocular Behcet's disease among siblings. Methods: We retrospectively studied five pairs of siblings with ocular involvement of Behcet's disease. No other family member of these siblings had any symptom of Behcet's disease. Results: The siblings comprised three sister-brother pairs, one sister-sister pair, and one brother-brother pair. There was a 5-10-year difference between the age at onset of ocular disease among siblings. Three of the five pairs (two sister-brother, one brother-brother) had a dissimilar course of disease activity. Female siblings had an earlier age at onset and tended to have a worse prognosis than their brothers. Conclusions: It is generally acknowledged that male sex is associated with a worse prognosis. In this study, however, we observed that, among siblings with a dissimilar course, female patients were more severely affected than male patients. Poor ocular prognosis in a patient does not indicate aggressive treatment in his/her sibling. We believe that each sibling should be managed on an individual basis.