International Journal of Colorectal Disease

, Volume 25, Issue 11, pp 1371–1376 | Cite as

Chronological changes in the systemic manifestations of intestinal Behcet’s disease and their significance in diagnosis

  • Sung Jae Shin
  • Sang Kil Lee
  • Tae Il Kim
  • Jae Hee Cheon
  • Eun Soo  Kim
  • Byung Chang Kim
  • Sooyoung Park
  • Won Ho KimEmail author
Original Article



Intestinal Behçet's disease (BD) is challenging to diagnose, especially if the patient presents with typical colonoscopic findings of intestinal BD without systemic manifestations of BD. We performed this study to evaluate the systemic manifestations of BD in patients with typical colonoscopic findings of intestinal BD at the time of initial presentation and to identity the chronologic changes of these features during an extended follow-up period.


One hundred twenty-six consecutive patients who showed typical colonoscopic findings of intestinal BD at a single institution in Korea were enrolled. Clinical and endoscopic data were collected from a medical database and using a written questionnaire. Parameters including demographic characteristics and the subset type of BD at the initial and endpoints of the follow-up were analyzed.


The mean follow-up period was 63.9 ± 50.9 months. The number of cases that satisfied the International Study Group for Behçet’s Disease criteria at initial diagnosis, 19.0%, increased to 53.2% by the end of follow-up. When the Japanese criteria were used for classification, the proportion of complete and incomplete type BD increased (2.4% and 26.2% to 18.3% and 49.2%, respectively), while that of suspected and not-satisfied subtype BD decreased (22.2% and 49.2% to 19.0% and 13.5%, respectively) during the follow-up period.


Our data suggest that patients who lack the systemic manifestations of BD could be included in the category of intestinal BD when typical intestinal lesion is identified, indicating that close examination and early treatment should be considered in such patients.


Intestinal Behçet's disease Diagnostic criteria Subset type Chronological change 


  1. 1.
    Sakane T, Takeno M, Suzuki N et al (1999) Behcet’s disease. N Engl J Med 341:1284–1291CrossRefPubMedGoogle Scholar
  2. 2.
    Marshall SE (2004) Behcet’s disease. Best Pract Res Clin Rheumatol 18:291–311PubMedGoogle Scholar
  3. 3.
    Yurdakul S, Tuzuner N, Yurdakul I et al (1996) Gastrointestinal involvement in Behcet’s syndrome: a controlled study. Ann Rheum Dis 55:208–210CrossRefPubMedGoogle Scholar
  4. 4.
    Yang SK (2005) Intestinal Behcet’s disease. Intest Res 3:1–10Google Scholar
  5. 5.
    Lakhanpal S, Tani K, Lie JT et al (1985) Pathologic features of Behcet’s syndrome: a review of Japanese autopsy registry data. Hum Pathol 16:790–795CrossRefPubMedGoogle Scholar
  6. 6.
    Lee CR, Kim WH, Cho YS et al (2001) Colonoscopic findings in intestinal Behcet’s disease. Inflamm Bowel Dis 7:243–249CrossRefPubMedGoogle Scholar
  7. 7.
    Mason RM, Barnes CG (1969) Behcet’syndrome with arthritis. Ann Rheum Dis 28:95–103CrossRefPubMedGoogle Scholar
  8. 8.
    Mizushima Y, Inaba G, Mimura Y et al (1988) Diagnostic criteria for Behcet’s disease in 1987, and guideline for treating Behcet’s disease. Saishin Igaku 43:391–393Google Scholar
  9. 9.
    International Study Group for Behcet’s Disease (1990) Criteria for diagnosis of Behcet’s disease. Lancet 335:1078–1080Google Scholar
  10. 10.
    Lee SK, Kim BK, Kim TI et al (2009) Differential diagnosis of intestinal Behcet’s disease and Crohn’s disease by colonoscopic findings. Endoscopy 41:9–16CrossRefPubMedGoogle Scholar
  11. 11.
    Nagasako K (1982) Differential diagnosis of colorectal diseases, 1st edn. Igaku-Syoin, TokyoGoogle Scholar
  12. 12.
    Blundell CR, Earnest DL (1980) Idiopathic cecal ulcer. Diagnosis by colonoscopy followed by nonoperative management. Dig Dis Sci 25:494–503CrossRefPubMedGoogle Scholar
  13. 13.
    Ona FV, Allende H, Vivenzio R et al (1982) Diagnosis and management of nonspecific colon ulcer. Arch Surg 117:888–894PubMedGoogle Scholar
  14. 14.
    Khawaja FI, Vakil N (1987) Colonoscopy as an aid in the diagnosis of nonspecific ulcers of the colon. Gastrointest Endosc 33:43–45CrossRefPubMedGoogle Scholar
  15. 15.
    Muto T (1979) Historical review of so called “simple ulcer” of the intestine. Stomach Intestine 14:739–748Google Scholar
  16. 16.
    Takaki Y, Yao T, Matsui T et al (2003) Comparison of radiographic and endoscopic findings in simple ulcer and intestinal Behcet’s disease: the difference between the GI tract lesions. Stomach Intestine 38:214–227Google Scholar
  17. 17.
    Iida M (1992) Clinical course of intestinal lesions in patients with intestinal disease and simple ulcer. Stomach Intestine 27:287–302Google Scholar
  18. 18.
    Jung HC, Rhee PL, Song IS et al (1991) Temporal changes in the clinical type or diagnosis of Behcet’s colitis in patients with aphthoid or punched-out colonic ulcerations. J Korean Med Sci 6:313–318PubMedGoogle Scholar
  19. 19.
    Kim DK, Yang SK, Byeon JS et al (2005) Clinical manifestations and course of intestinal Behcet’s disease: an analysis in relation to disease subtypes. Intest Res 3:48–54Google Scholar
  20. 20.
    Kim JE, Han DS, Cho HS et al (2007) Clinical features of intestinal Behcet’s disease according to disease subtypes. Intest Res 5:26–32Google Scholar
  21. 21.
    Lee S (1997) Diagnostic criteria of Behcet’s disease: problems and suggestions. Yonsei Med J 38:365–369PubMedGoogle Scholar
  22. 22.
    Kim HJ, Bang D, Lee SH et al (1988) Behcet’s syndrome in Korea: a look at the clinical picture. Yonsei Med J 29:72–78PubMedGoogle Scholar
  23. 23.
    James DG (1979) Behcet’s syndrome. N Engl J Med 301:431–432CrossRefPubMedGoogle Scholar
  24. 24.
    Friedman-Birnbaum R, Bergman R, Aizen E (1990) Sensitivity and specificity of pathergy test results in Israeli patients with Behcet's disease. Cutis 45:261–264PubMedGoogle Scholar
  25. 25.
    Yoon MS, Lee SH, Bang D et al (1987) Cutaneous manifestations of Behcet’s syndrome. Yonsei Med J 28:291–296PubMedGoogle Scholar
  26. 26.
    Nakae K, Masaki F, Hashimoto T et al (1993) Recent epidemiological features of Behcet’s disease in Japan. In: Wechsler B, Godeau P (eds) Behcet's disease. Excerpta Medica, Amsterdam, pp 145–151Google Scholar

Copyright information

© Springer-Verlag 2010

Authors and Affiliations

  • Sung Jae Shin
    • 1
  • Sang Kil Lee
    • 1
  • Tae Il Kim
    • 1
  • Jae Hee Cheon
    • 1
  • Eun Soo  Kim
    • 1
  • Byung Chang Kim
    • 1
  • Sooyoung Park
    • 1
  • Won Ho Kim
    • 1
    Email author
  1. 1.Department of Internal Medicine, Institute of GastroenterologyYonsei University College of MedicineSeoulKorea

Personalised recommendations