Et al. [2], and Gurgey et al. [14] from Turkey, Mammo et al.

Et al. [2], and Gurgey et al. [14] from Turkey, Mammo et al. [15] from Saudi Arabia, Navarro et al. [16] from Spain), while other studies reported that there was no significant association ( Toydemir et al. [17] from Turkey, Verity et al. [18] from Jordan, Silingardi et al. [19] from Italy). As many epidemiologic studies supported, mild hyperhomocysteinemia was found to be a risk factor for both venous and arterial thrombosis. Endothelial dysfunction due to inflammation is considered to be an important factor of thrombosis in BD. Homocysteine is reported to enhance endothelial-leukocyte interaction. Some studies have shown that hyperhomocysteinemia might act as independent and correctable risk factor for thrombosis in BD. Moreover, the association between homocysteine levels and endothelial dysfunction has been shown in patients with BD [11]. In our study, we measured plasma homocysteine level in 10 selected patients with vascular complications after exclusion of disease or drugs affecting homocysteine levels. We detected elevated levels in 3 patients (33.3 ). Evaluation of association between specific individual clinical manifestations and hyperhomocysteinemia in our study revealed higher prevalence in patients with ocular and cardiac lesions. There are several studies that evaluated hyperhomocysteinemia in BD patients and their results were conflicting. Aksu et al. [20], detected hyperhomocysteinemia in BD patients with a history of thrombosis. The significance of hyperhomocysteinemia in ocular behcet’s was evaluated by Okka et al. [21]; they suggested that hyperhomocysteinemia may play a role in ocular involvement of BD.In conclusion, This study detected PubMed ID: a higher prevalence of activated protein C resistance in patients with Behcet’s disease (18.8 ) than the control (6 ), and was higher in patients with vascular manifestations than those without (29 versus 6.6 respectively) but without statistical significance. Although there was more incidence of positive test for APC resistance in our patients we could not detect statistically significant difference, the number of the patients could be a limiting factor and further studies with higher number of patients are required. Homocysteine is a risk factor for thromboembolism in BD (30 had hyperhomocysteinemia). Hyperhomocysteinemia is correlated to ocular lesions, but studies with large number of patients will be required to give strong evidence. The data about hypercoagulablity in BD could have therapeutic implication in the management of deep vein thrombosis and arterial thrombosis in patients with BD. The current recommendations does not suggest the use of anticoagulation for the vascular lesions of BD and suggest the use of immunosuppressive medications only based on the theory that the primary pathology leading to venous thrombosis in BD is the inflammation of vessel wall [22].Competing interests The authors declare that they 3-Chloro-5-cyclopropylpyridine have no competing interests. Authors’ contributions All authors performed the design, acquisition and validation of data. All authors approved the final version of PubMed ID: article. Author details 1 Department of Internal Medicine, Cairo University, 3-Nitro-6-(trifluoromethyl)pyridin-2(1H)-one Cairo, Egypt. 2 Department of Internal Medicine, University of Missouri-Kansas City, Kansas, USA. 3Department of Clinical Pathology, Cairo University, Cairo, Egypt. 4 Department of Internal Medicine, Fayoum University, Fayoum, Egypt. Received: 20 March 2013 Accepted: 9 July 2013 Published: 2 September 2013 References 1. Koc.