Analysis Of Clinical Characteristics Of 43 Intestinal Behcet's Disease

BackgroundBehcet's disease,also known as Behcet's syndrome,can be called "Silk Road Disease" because of its high incidence near the Mediterranean to East Asia.This disease is a chronic recurrent inflammatory disease that can affect multiple systems throughout the body.The main clinical features are recurrent oral ulcers,genital ulcers,skin damage,eye damage,etc.,as well as the manifestations of blood vessels,gastrointestinal tract,nerves,kidneys,joints and the like.The typical histopathological feature is vasculitis,which can be involved in almost all blood vessels throughout the body.The pathogenesis of Behcet's disease is still unclear and may be related to various factors such as environment,genetics and immunity.Infection may be the cause.Behcet's disease is called intestinal Behcet's disease when it involves the gastrointestinal tract.The digestive tract from the oral cavity to the anus can be affected.At present,the incidence of intestinal Behcet is low,and the diagnosis depends mainly on clinical manifestations.In clinical work,we should pay attention to intestinal Behcet's disease,strengthen the understanding of intestinal Behcet's disease,and avoid misdiagnosis and missed diagnosis.ObjectiveAnalysis of clinical data of 43 cases of intestinal Behcet's disease in the First Affiliated Hospital of Zhengzhou University,and summarize the clinical characteristics of intestinal Behcet's disease,in order to improve our understanding of intestinal Behcet's disease in clinical work.Method43 patients of intestinal behcet's disease were collected from January 2015 to April 2018 in the first affiliated hospital of Zhengzhou university.The patient's general data,clinical manifestations,laboratory tests,imaging studies,digestive endoscopy results,treatment and prognosis were retrospectively analyzed.ResultOf the 43 patients of intestinal Behcet's disease,20 were male and 23 were female.The average onset age was 32.79±11.70 years old.And there was no significant difference in age of onset between male and female.There was also no significant difference in gender among different age groups.The course of disease ranged from 3 days to 17 years(median,6 months).The course of disease was significantly longer in women than men.All of the 43 patients in this group had oral ulcers,of which 81.39% of the digestive symptoms occurred after other symptoms.The most common digestive symptoms are abdominal pain(65.11%).Digestive system complications include gastrointestinal bleeding,digestive tract perforation,and intestinal obstruction.Endoscopic lesions were mainly located in ileocecal,terminal ileum and esophagus,accounting for 37.20%(16/43),34.88%(15/43)and 32.55%(14/43)respectively.The microscopic appearance is mainly ulcer.In this study,38 patients underwent histopathological examination.Endoscopic pathological biopsy was mainly characterized by chronic active inflammation of the mucosa with ulcer formation,lymphoid hyperplasia,chronic non-specific inflammation of the mucosa,granulation tissue hyperplasia,chronic inflammation with necrotic exudation and vasculitis,lymphoid follicle formation,focal granuloma,etc.35 patients were treated with hormones,including hormones alone and combined with immunosuppressive agents or thalidomide.Except for 4 patients who were ineffective with hormones alone,the rest were alleviated.4 patients were treated with thalidomide or immunosuppressive agents alone without hormone therapy.Except for one patient who was ineffective with thalidomide alone,the rest were alleviated.6 patients underwent surgical treatment due to misdiagnosis or serious complications during treatment(Two of them underwent surgical treatment for complications during drug treatment.).Conclusion1.Intestinal Behcet's disease occurs mostly in young adults,and there is no significant difference in the age of onset between men and women.2.Digestive symptoms of intestinal Behcet's disease often appear after systemic symptoms and are easily misdiagnosed and missed.3.Endoscopic manifestations of intestinal Behcet's disease are mainly ileocecal,terminal ileum and esophagus.Usually multiple sites are involved.4.At present,intestinal Behcet's disease are mainly treated with glucocorticoids,thalidomide,immunosuppressants and 5-ASA drugs,which can be alleviated.Surgical treatment is feasible when complications occur.