Clinical features of pseudo-Behcet’s syndrome:
(1) The patient is usually female (female to male ratio 10:1).
(2) The patient is usually a young or middle-aged adult.
(3) The patient gives a history of seeing many physicians or being admitted to multiple hospitals (extensive medical workup).
(4) The patient uses or abuses narcotics.
(5) The patient may claim multiple drug allergies.
(6) The patient is usually knowledgable about medicine and may work in a clinical setting.
(7) The patient gives a list of symptoms suggestive of Behcet’s disease.
(8) The patient has no or few objective findings on physical exam, with none of the classic findings (uveitis, focal neurological deficit).
(9) The patient may have self-inflicted injuries.
(10) Markers of inflammation (erythrocyte sedimentation rate, C-reactive protein) are normal or only slightly elevated.
Levine and O’Duffy recommend that the diagnosis of Behcet’s syndrome not be accepted until the patient has undergone a physical examination by a physician familiar with Behcet’s syndrome.
