Abstract
Purpose
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.
Methods
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.
Results
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.
Conclusions
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.
Similar content being viewed by others
References
Sakane T, Takeno M, Suzuki N et al (1999) Behcet’s disease. N Engl J Med 341:1284–1291
Marshall SE (2004) Behcet’s disease. Best Pract Res Clin Rheumatol 18:291–311
Yurdakul S, Tuzuner N, Yurdakul I et al (1996) Gastrointestinal involvement in Behcet’s syndrome: a controlled study. Ann Rheum Dis 55:208–210
Yang SK (2005) Intestinal Behcet’s disease. Intest Res 3:1–10
Lakhanpal S, Tani K, Lie JT et al (1985) Pathologic features of Behcet’s syndrome: a review of Japanese autopsy registry data. Hum Pathol 16:790–795
Lee CR, Kim WH, Cho YS et al (2001) Colonoscopic findings in intestinal Behcet’s disease. Inflamm Bowel Dis 7:243–249
Mason RM, Barnes CG (1969) Behcet’syndrome with arthritis. Ann Rheum Dis 28:95–103
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 43:391–393
International Study Group for Behcet’s Disease (1990) Criteria for diagnosis of Behcet’s disease. Lancet 335:1078–1080
Lee SK, Kim BK, Kim TI et al (2009) Differential diagnosis of intestinal Behcet’s disease and Crohn’s disease by colonoscopic findings. Endoscopy 41:9–16
Nagasako K (1982) Differential diagnosis of colorectal diseases, 1st edn. Igaku-Syoin, Tokyo
Blundell CR, Earnest DL (1980) Idiopathic cecal ulcer. Diagnosis by colonoscopy followed by nonoperative management. Dig Dis Sci 25:494–503
Ona FV, Allende H, Vivenzio R et al (1982) Diagnosis and management of nonspecific colon ulcer. Arch Surg 117:888–894
Khawaja FI, Vakil N (1987) Colonoscopy as an aid in the diagnosis of nonspecific ulcers of the colon. Gastrointest Endosc 33:43–45
Muto T (1979) Historical review of so called “simple ulcer” of the intestine. Stomach Intestine 14:739–748
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 38:214–227
Iida M (1992) Clinical course of intestinal lesions in patients with intestinal disease and simple ulcer. Stomach Intestine 27:287–302
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 6:313–318
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 3:48–54
Kim JE, Han DS, Cho HS et al (2007) Clinical features of intestinal Behcet’s disease according to disease subtypes. Intest Res 5:26–32
Lee S (1997) Diagnostic criteria of Behcet’s disease: problems and suggestions. Yonsei Med J 38:365–369
Kim HJ, Bang D, Lee SH et al (1988) Behcet’s syndrome in Korea: a look at the clinical picture. Yonsei Med J 29:72–78
James DG (1979) Behcet’s syndrome. N Engl J Med 301:431–432
Friedman-Birnbaum R, Bergman R, Aizen E (1990) Sensitivity and specificity of pathergy test results in Israeli patients with Behcet's disease. Cutis 45:261–264
Yoon MS, Lee SH, Bang D et al (1987) Cutaneous manifestations of Behcet’s syndrome. Yonsei Med J 28:291–296
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 145–151
Author information
Authors and Affiliations
Corresponding author
Additional information
This paper was presented at the United European Gastroenterology Week, Berlin, Germany, October 21-25, 2006, as a poster of distinction.
Rights and permissions
About this article
Cite this article
Shin, S.J., Lee, S.K., Kim, T.I. et al. Chronological changes in the systemic manifestations of intestinal Behcet’s disease and their significance in diagnosis. Int J Colorectal Dis 25, 1371–1376 (2010). https://doi.org/10.1007/s00384-010-0968-8
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00384-010-0968-8