J Rheum Dis.  2013 Dec;20(6):369-373. 10.4078/jrd.2013.20.6.369.

A Case of Behcet's Disease Associated with Schizophrenia and Myelodysplastic Syndrome with Trisomy 8 and 9

• Baek JH
• Chun HJ
• Park YH
• Cho JH
• Bae SK
• Ha YJ

• KMID: 2222996
• DOI: http://doi.org/10.4078/jrd.2013.20.6.369

Abstract

Behcet's disease (BD) is a multi-systemic inflammatory disease of unknown origin that affects nearly all organs. Recent reports of BD with myelodysplastic syndrome (MDS) often note an association with gastrointestinal involvement and trisomy 8. We herein report on a case of a 51-year-old man who had refractory schizophrenia and developed gastrointestinal BD and MDS with trisomy 8 and 9. He visited our hospital due to fever and abdominal pain. Multiple ulcerations in the colorectum were observed on colonoscopy, and he was diagnosed with intestinal BD. During the treatment of intestinal BD, anemia and thrombocytopenia developed. His bone marrow study revealed myelodysplastic syndrome (refractory anemia with ringed sideroblast) with trisomy 8 and trisomy 9. We report a rare case of intestinal BD accompanied by schizophrenia and myelodysplastic syndrome with trisomy 8 and 9.

Keyword

Behcet's disease; Myelodysplastic syndrome; Schizophrenia

MeSH Terms

Abdominal Pain
Anemia
Bone Marrow
Colonoscopy
Fever
Humans
Middle Aged
Myelodysplastic Syndromes*
Schizophrenia*
Thrombocytopenia
Trisomy*
Ulcer

Figure

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  Figure 1. Initial colonoscopy showed well demarcated multiple ulcers at descending colon.

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  Figure 2. Abdominal computed tomography scan showed mass- like lesion with contrast enhancement around terminal ileum (A). Followup colonoscopy showed inflammatory polyp at the ileo-cecal valve (B).

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  Figure 3. Microscopic findings of bone marrow aspiration showed myeloid dysplasia such as hypogranulation and hypolobulation, and dyspoietic erythroid precursors, such as nuclear irregularity (Wright-Giemsa stain: original magnifications ×1,000).

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  Figure 4. Cytogenetic study of bone marrow aspiration. This study was performed on Giemsa banded chromosomes obtained from 24 hour-cultured bone marrow cells. All of examined twenty cells show extrachromosome 8 and extrachromosome 9, karyotype: 48:XY, +8, +9.

Reference

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