Association of Colonoscopic Findings and Clinical Symptoms of Intestinal Involvement in Behcet's Disease

Introduction. Behcet's disease is multisystemic vasculitis which affects vein and artery blood vessels. Intestinal perforation rarely occurs as clinic manifestation in as litle as 1% of patients. The transverse colon is the most infrequent site of perforation. We presented a patient diagnosed with Behcet's disease who underwent both surgical and conversative treatment due to perforation of the colon. Case report. A 34-year-old patient was admitted to the hospital with fever, aphthous ulcerations on oral mucosa and genitals and bilateral uveitis. On the basis of clinical symptoms and the International Criteria developed in 1990 Behcet's disease was diagnosed. During the next few days the patient developed erythema nodosum, diarrheic syndrome and acute abdominal symptoms due to perforation of the transverse colon. An emergent laparotomy was undertaken involving resection of a perforated segment of the colon, and bipolar colostomy on the left side of abdomen. Following the surgery the patient was treated except for antibiotics with three successive pulse doses of methylprednisolone (500 mg/daily) and cyclophosphamide (15 mg/kg). The treatment was continued by gradual decrease in the close of the corticosteroid (perorally) and by cyclophosphamide first with monthly doses (5 monthly pulse doses of 15 mg/kg cyclophosphoamide), and then with 3-month doses (totally 6 doses) up to totally 12 g. Conclusion. The therapy with pulse doses of methylprednisolone combined with pulse doses of cyclophosphamide was very effective in the reported case with the complex clinical manifestations leading to resolution of gastrointenstinal, ocular and orogenital lesions.

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Features of systemic cytokine production in Behcet's disease associated with uveitis without ocular lesions

Medical Immunology (Russia) ◽

10.15789/1563-0625-fos-2341 ◽

2021 ◽

Vol 23 (5) ◽

pp. 1079-1088

Author(s):

E. S. Sorozhkina ◽

G. I. Krichevskaya ◽

N. V. Balatskaya ◽

I. G. Kulikova ◽

A. E. Andryushin ◽

...

Keyword(s):

Behçet’S Disease ◽

Detection Rate ◽

Behcet’S Disease ◽

Clinical Symptoms ◽

Behçet's Disease ◽

Systemic Disease ◽

Control Group ◽

People Detection ◽

Detection Rates ◽

Behcet's Disease

Behcet's disease (BD) is a systemic disease underlyed by chronic vasculitis. Hyperactivity of innate and adaptive immunity plays important role in its pathogenesis. Uveitis occurs in 30-70% of the patients, often recurring and reducing visual function. The objective of our work was to study the features of systemic production of immune mediators in BD patients, depending on presence and activity of uveitis. 116 BD patients were divided into 3 groups: (1) 41 patients with active uveitis (UA), (2) 64 subjects with uveitis remission (UR), (3) 11 uveitis-free BD patients (WU). Control group (CG) comprised 34 conditionally healthy people. Detection rate (%) and contents (pg/ml) were measured for IL-1β IL-2, IL-4, IL-5, IL-6, IL-12p70, IL-13, IL-18, IFNγ, CCL2/MCP-1, CCL3/MIP-1α, CCL4/MIP-1β, CCL5/RANTES, CCL11/Eotaxin, СXCL1/GRO-α, CXCL8/IL-8, CXCL10/IP-10, CXCL12/SDF-1α, GM-CSF, TNFα in blood serum by means of multiplex analysis using MAGPIX analyzer (Luminex Corp., USA), Procarta Plex “Human Th1/Th2&Chemokine Panel 20 plex” kits (Bioscience, Austria). TGF-P1, TGF-P2 levels were assayed by ELISA-test (“Vfector-Best”). All the BD patients showed high detection rates of CXCL1/GRO-α (but not its level) in comparison with CG. Detection rate and levels of IL-6, IL-8 were increased in 1st and 2nd BD groups, compared to CG. In UR, unlike UA and WU groups, IL-4 was detected more often than in CG. WU patients showed increased detection rate of only CXCL1/GRO -α. When compared with UA, WU patients had lower serum concentrations of IFNγ, MCP-1, IP-10, MIP-1a, SDF-1α, TGF-β1; UR patients also showed decreased serum levels of IL-18, Eotaxin, GRO-α, RANTES, TGF-β2. Our results indicate the importance of angiogenic and proinflammatory chemokines and cytokines in pathogenesis of BD uveitis, as well as imbalanced production of various immunomediators. Higher detection rates and levels of IL-6 and IL-8 in UA and UR patients may result from weak persistent intraocular inflammation, even upon relief of clinical symptoms, thus, probably, requiring therapeutic correction.

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Radiological Findings of Esophageal and Intestinal Involvement in Behcet's Disease

Journal of the Korean Radiological Society ◽

10.3348/jkrs.1984.20.2.314 ◽

1984 ◽

Vol 20 (2) ◽

pp. 314

Author(s):

C H Suh ◽

B I Choi

Keyword(s):

Behçet’S Disease ◽

Behcet’S Disease ◽

Behçet's Disease ◽

Radiological Findings ◽

Behcet's Disease ◽

Intestinal Involvement

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Interferon- treatment for acute myelitis and intestinal involvement in severe Behcet's disease

QJM ◽

10.1093/qjmed/hcq125 ◽

2010 ◽

Vol 103 (10) ◽

pp. 787-790 ◽

Cited By ~ 11

Author(s):

A. Monastirli ◽

E. Chroni ◽

S. Georgiou ◽

J. Ellul ◽

E. Pasmatzi ◽

...

Keyword(s):

Behçet’S Disease ◽

Behcet’S Disease ◽

Behçet's Disease ◽

Interferon Treatment ◽

Behcet's Disease ◽

Intestinal Involvement

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P104. Fecal calprotectin as a non-invasive biomarker for intestinal involvement of Behcet's disease

Journal of Crohn s and Colitis ◽

10.1093/ecco-jcc/jju027.221 ◽

2015 ◽

Vol 9 (suppl 1) ◽

pp. S128-S129

Keyword(s):

Behçet’S Disease ◽

Behcet’S Disease ◽

Behçet's Disease ◽

Fecal Calprotectin ◽

Behcet's Disease ◽

Non Invasive ◽

Intestinal Involvement

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P261 Clinical usefulness of fecal calprotectin measurement in predicting intestinal involvement of Behçet's disease: preliminary results

Journal of Crohn s and Colitis ◽

10.1016/s1873-9946(14)60382-2 ◽

2014 ◽

Vol 8 ◽

pp. S172

Author(s):

D.H. Kim ◽

B. Kim ◽

S.J. Park ◽

S.P. Hong ◽

T.I. Kim ◽

...

Keyword(s):

Behçet’S Disease ◽

Behcet’S Disease ◽

Behçet's Disease ◽

Fecal Calprotectin ◽

Clinical Usefulness ◽

Behcet's Disease ◽

Preliminary Results ◽

Intestinal Involvement

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The Role of Fecal Calprotectin in Evaluating Intestinal Involvement of Behçet’s Disease

Disease Markers ◽

10.1155/2016/5423043 ◽

2016 ◽

Vol 2016 ◽

pp. 1-5 ◽

Cited By ~ 6

Author(s):

Burak Özşeker ◽

Cem Şahin ◽

Havva Solak Özşeker ◽

S. Cumali Efe ◽

Taylan Kav ◽

...

Keyword(s):

Behçet’S Disease ◽

Behcet’S Disease ◽

Behçet's Disease ◽

Fecal Calprotectin ◽

Unknown Etiology ◽

Control Group ◽

Behcet's Disease ◽

Intestinal Involvement ◽

Gi Symptoms

One of the regions of involvement of Behçet’s disease (BD), a systematic inflammatory vasculitis with unknown etiology, is the gastrointestinal (GI) tract. Upper GI endoscopy, colonoscopy, and capsule endoscopy are frequently used methods to diagnose the intestinal involvement of BD. The aim of this study was to investigate the role of fecal calprotectin (FC) in the evaluation of intestinal involvement in BD.Material and Method. A total of 30 patients who were diagnosed with BD and had no GI symptoms and 25 individuals in the control group were included in this study.Results. Levels of FC were statistically significantly higher in patients with BD compared to the control group (p<0.001). The correlation analysis performed including FC and markers of disease activity revealed a positive and statistically significant correlation between FC level and CRP and erythrocyte sedimentation rate (r: 0.255,p<0.049, andr: 0.404,p<0.001, resp.). FC levels in patients who were detected to have ulcers in the terminal ileum and colon in the colonoscopic examination were statistically significantly higher compared to the patients with BD without intestinal involvement (p=0.01).Conclusion. The measurement of FC levels, in patients with BD who are asymptomatic for GI involvement, may be helpful to detect the possible underlying intestinal involvement.

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