Intest Res.  2017 Jul;15(3):311-317. 10.5217/ir.2017.15.3.311.

Optimal diagnosis and disease activity monitoring of intestinal Behçet's disease

• Lee HJ
• Cheon JH

• KMID: 2382374
• DOI: http://doi.org/10.5217/ir.2017.15.3.311

Abstract

Intestinal Behçet's disease (BD), generally accepted as a type of inflammatory bowel disease (IBD), could be diagnosed when patients with BD have objectively documented gastrointestinal symptoms and intestinal ulcerations. Similar to IBD, intestinal BD has an unpredictable disease course with relapse and remission and is often related to a poor prognosis. However, there is no single gold standard for assessment of the disease activity of intestinal BD, and its diagnosis and management depend heavily on expert opinions. The Korean IBD Study Group recently developed novel diagnostic criteria based on colonoscopy findings and clinical manifestations using a modified Delphi process to overcome drawbacks of previously used consensus for the diagnosis of intestinal BD. In addition, the recently developed disease activity index for intestinal BD, consisting of a relatively simple 8-point index, could also help in determining treatment strategies and monitoring therapeutic responses. In this review, the progress in the diagnosis and disease activity measurement of intestinal BD will be discussed.

Keyword

Behcet Syndrome; Inflammatory bowel disease; Diagnostic criteria; Disease activity index

MeSH Terms

Behcet Syndrome
Colonoscopy
Consensus
Diagnosis*
Expert Testimony
Humans
Inflammatory Bowel Diseases
Prognosis
Recurrence
Ulcer

Figure

• 

  Fig. 1 Colonoscopic findings of intestinal Behçet's disease. (A, B) Typical ulcers for intestinal Behçet's disease are defined as single or few deep oval-shaped ulcers with discrete margins in the ileocecal area. (C, D) Atypical ulcers for intestinal Behçet's disease are defined as intestinal ulcerations that do not meet all of these characteristics, such as aphthous or shallow ulcers in the ileocecal area.

• 

  Fig. 2 Algorithm for the diagnosis of intestinal Behçet's disease (BD) based on the type of ileocolonic ulcerations and clinical manifestations. aThe subtypes of systemic BD (complete, incomplete, and suspected) were classified in accordance with the diagnostic criteria of the Research Committee of Japan; bA close follow-up is necessary. Adapted from Cheon JH, et al.29

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