Yonsei Med J.  2013 Sep;54(5):1084-1090. 10.3349/ymj.2013.54.5.1084.

Outcome Predictors for Intestinal Behcet's Disease

• Park JJ
• Kim WH
• Cheon JH

• KMID: 1793153
• DOI: http://doi.org/10.3349/ymj.2013.54.5.1084

Abstract

Behcet's disease (BD) is a multisystem inflammatory disorder that presents as recurrent oral and genital ulcers in conjunction with other dermatological and ocular manifestations. The prevalence of BD is higher in Middle and East Asia than in Western countries. Intestinal BD is a specific subtype of BD, characterized by intestinal ulcers and associated gastrointestinal symptoms. Similar to inflammatory bowel disease, intestinal BD exhibits a fluctuating disease course with repeated episodes of relapse and remission that necessitate adequate maintenance therapy after achievement of clinical remission. Medical treatment of intestinal BD is largely empirical since well-controlled studies have been difficult to perform due to the heterogeneity and rarity of the disease. To date, 5-aminosalicylic acid, systemic corticosteroids, and immunosuppressants have been used anecdotally to treat intestinal BD. The clinical course of intestinal BD shows considerable variability, and the exact point at which more potent agents such as immunosuppressants should be used has not yet been elucidated. Given the difficulty in predicting which patients will experience complicated disease courses and the fact that these drugs are related with certain risk resulting from immunosuppression, proper identification of prognostic factors in intestinal BD may allow physicians to implement tailored medical therapy and individualized patient monitoring based on risk stratification. In this review, the impact of baseline characteristics on the long-term course of intestinal BD, prognostic factors during various medical therapies, and outcome predictors related to surgery will be discussed.

Keyword

Intestinal Behcet's disease; prognostic factors; medical treatment; surgical treatment

MeSH Terms

Adrenal Cortex Hormones/adverse effects/therapeutic use
Adult
Age Factors
Behcet Syndrome/*diagnosis/pathology/therapy
Female
Humans
Immunosuppressive Agents/adverse effects/therapeutic use
Immunotherapy
Intestinal Diseases/*diagnosis/pathology/therapy
Male
Prognosis
Sex Factors
Adrenal Cortex Hormones
Immunosuppressive Agents

Figure

• 

  Fig. 1 Volcano-type ulcers in patients with intestinal Behçet's disease. The ileocolonoscopic findings show large, well-demarcated, deeply penetrating ulcers with nodular margins.

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