To the Editor:
I read with interest the review article (August 2000) on intracardiac thrombus in Behcet's disease (BD) by Mogulkoc et al. Having recently returned from a visit to Turkey and Greece, I would like to make some comments, especially from the historical point of view.
First, Hulusi Behcet was a Turkish dermatologist from Istanbul (1889-1948). To commemorate his contribution to the syndrome that now bears his name, the University of Istanbul, where I served as a Visiting Professor during my recent visit, named the medical library after him (Fig 1).
[Figure 1 ILLUSTRATION OMITTED]
Second, having visited the island of Kos, the birthplace of Hippocrates, during my visit to Greece, where I served as a Visiting Professor at the University of Athens, I came to recognize that the first description of the symptomatology of BD was actually reported by Hippocrates. In fifth century BC, Hippocrates wrote in his third book of epidemiology:
Third, although Mogulkoc et al did not mention mitral valve prolapse (MVP) in their article, there is a high incidence of MVP in patients with BD, occurring in 50% of cases.[4,5] The association of MVP and BD was first reported in China.[5,6] Shen et al, from Shanghai, China, postulated that MVP may have been the result of structural damage and functional derangement caused by the underlying vasculitis of BD. Whereas the association of MVP and BD may be either causally related or coincidental, it is important to keep in mind that, although BD is relatively rare in the United States, MVP is very common.
BD occurs most frequently in Japan and in the Mediterranean countries, and also in the population linking these two areas to each other. It occurs most frequently between latitudes 30 [degrees] and 45 [degrees] north, in Asian and Eurasian populations. This area coincides with the old Silk Route. Thus, BD is often also called "Silk Route disease."
Correspondence to: Tsung O. Cheng, MD, FCCP, Professor of Medicine, The George Washington University, 2150 Pennsylvania Ave NW, Washington, DC 20037-3201
 Mogulkoc N, Burgess MI, Bishop PW. Intracardiac thrombus in Behcet's disease: a systematic review. Chest 2000; 118:479-487
 Cheng TO. Behcet's disease [letter]. N Engl J Med 2000; 342:588
 Kaklamani VG, Vaiopoulos G, Kaklamanis PG. Behcet's disease. Semin Arthritis Rheum 1998; 27:197-217
 Morelli S, Perrone C, Ferrante L, et al. Cardiac involvement in Behcet's disease. Cardiology 1997; 88:513-517
 Shen L-L, Cui G-G, Liang R-L. Valve prolapse in Behcet's disease. Br Heart J 1985; 54:100-101
 Cheng TO. Behcet's disease ("Silk Route disease") and mitral valve prolapse [letter]. Cardiology 1998; 89:306
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