The Clinical Analysis Of 29 Cases With Intestinal Behcet's Disease

1.Objective:To analyze the clinical characteristics of intestinal Behcet's disease, and provide the knowledge of its diagnosis and therapy.2.Methods:According to the International Study Group for Behcet's Disease diagnostic criter and classification of Behcet's disease(BD),29 patients,who involved definite gastrointestinal system manifestations,were diagnosed as Behcet's disease from January 1986 to December 2006 in Peking Union Medical College Hospital.Their clinical data were analyzed retrospectively by SPSS 13.0.3.Results:①The median age at onset of the patients with intestinal Bechet's was 26 years old with long clinical courses.Ratio of male to female was 1:1.23.②Clinical symptoms and signs of gastrointestinal were appearance later than that of systemic manifestation of BD in 93.1%cases.Abdominal pain was the most common symptom,the rate was 93.1%,and frequently represented on right-lower abdomen(15/27).The chief complaints of the patients with intestinal Behcet's disease were gastrointestinal bleeding(41.4%),obstruction(24.1%),perforation (17.2%) and intestinal fistula(10.3%) in turn.③Both ESR(92.3%) and CRP (92.0%) were increased which were common abnormity of laboratory test.The positive rate of HLA-B5 was 30.8%(4/13).④54.5%of cases showed the gastrointestinal mucous membranes were thick by X ray.⑤By means of the endoscopy,69.6%(16/23)of the patients with intestinal Behcet's disease had ulcers located in the ileocecal.34.8%(8) only had one ulcer.Whole gastrointestinal tract involved only seen in 3 cases.95.7%(22/23) had ulcer by endoscopic in which 14 cases(60.8%) with solitary large shape ulcers and 9 cases (39.1%) with single or multiple irregular geographic ulcers.⑥Nether of the 25 endoscopic biopsy samples were found the inflammatory vasculitis performance, but 3 of 7 surgical-pathologic samples were positive.⑦The rate of misdiagnosis when the patients first visited was high,and most of them were diagnosed as appendicitis(7 cases,24.1%).⑧The main therapy of intestinal Behcet's disease included glucocorticoid hormone(28) and immunosuppressant(20),but the compliance of patients was poor,and it's easy to recurrence in the course of reducing the dose of glucocorticoid hormone or stopping using the medicine. Larger shape ulcers in intestinal Behcet's disease showed a less favorable response to medical treatment but a more frequent rate of recurrence.The patients who had recurrence or useless therapy with glucocorticoid hormone only, combined immunosuppressant had got an approving curative effect.9 cases had a history of operation,including 5 emergency surgeries for perforation;the operation procedures including the resection of ileocecal(4) and right hemicolectomy(3).⑨There's no significant difference between the complete BD and incomplete BD.4.Conclusion:①Most of the patients of intestinal Behcet's disease were young people,the clinic course was long and it's difficult to diagnose.②The clinical symptoms and signs of gastrointestinal often appearance later than the systemic manifestation of BD.Abdominal pain was the most common symptom.③The patients with intestinal Behcet's disease had ulcer which often located in the ileocecal in large shape ulcers.④The larger shape ulcers in intestinal Behcet's disease showed a less favorable response to medical treatment but a more frequent rate of recurrence.⑤The patients who had recurrence or useless therapy with glucocorticoid hormone only,combined immunosuppressant had get a approving curative effect.⑥There's no significant difference between the complete BD and incomplete BD.