Observational Study
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World J Gastroenterol. Dec 7, 2014; 20(45): 17171-17178
Published online Dec 7, 2014. doi: 10.3748/wjg.v20.i45.17171
Endoscopic findings of gastrointestinal involvement in Chinese patients with Behcet’s disease
Jun Zou, Yan Shen, Da-Nian Ji, Song-Bai Zheng, Jian-Long Guan
Jun Zou, Yan Shen, Jian-Long Guan, Division of Immunology and Rheumatology, Shanghai Key Laboratory of Clinical Geriatric Medicine, Huadong Hospital, Research Center on Aging and Medicine, Fudan University, Shanghai 200040, China
Da-Nian Ji, Center of Gastrointestinal Endoscopy, Huadong Hospital, Fudan University, Shanghai 200040, China
Song-Bai Zheng, Division of Gastroenterology, Huadong Hospital, Fudan University, Shanghai 200040, China
Author contributions: Zou J and Guan JL contributed equally to this work; Zou J, Zheng SB and Guan JL designed the research; Zou J, Shen Y and Ji DN performed the research; Zou J and Zheng SB analyzed the data; Zou J and Guan JL wrote the paper.
Correspondence to: Jian-Long Guan, MD, PhD, Professor of Rheumatology, Chief, Division of Immunology and Rheumatology, Shanghai Key Laboratory of Clinical Geriatric Medicine, Huadong Hospital, Research Center on Aging and Medicine, Fudan University, No. 221 West Yan’an Road, Shanghai 200040, China. guanjianlong@medmail.com.cn
Telephone: +86-21-62483180 Fax: +86-21-62486420
Received: August 17, 2014
Revised: September 19, 2014
Accepted: October 21, 2014
Published online: December 7, 2014
Abstract

AIM: To report the incidence, clinical features and outcomes of gastrointestinal (GI) involvement in Behcet’s disease (BD).

METHODS: A total of 168 consecutive patients with BD were screened and upper and lower GI endoscopies were performed in 148 patients. Four hundred age- and sex-matched controls were enrolled for comparison.

RESULTS: Fifty-two (35.1%) patients had GI lesions. After a mean follow-up of 10 mo, ileocecal ulcers had been confirmed in 20 patients, including active ulcer(s) in 18 patients, but no ileocecal ulceration was found in controls. GI symptoms were present in 14 patients with active ulcer(s), while 4 patients with smaller ulcer were asymptomatic. Endoscopic features of ileocecal ulcer were: a single ulcer (50%), larger than 1 cm in diameter (72.2%), and round/oval or volcano-type in shape (83.3%). Compared with patients without GI involvement, less ocular lesions, lower levels of albumin, erythrocyte count and hemoglobin, and higher levels of C-reactive protein and erythrocyte sedimentation rate were confirmed in the intestinal BD group. Four patients had esophageal ulcers in the BD group but no case in controls. The other endoscopic findings were similar between the two groups. The prevalence of Helicobacter pylori infection was similar in both groups. Most patients received an immunomodulator and responded well.

CONCLUSION: GI lesions commonly occur in Chinese BD patients. The most frequently involved area is the ileocecal region. Esophageal ulcer might be a rare but unique lesion.

Keywords: Behcet’s disease, Gastrointestinal involvement, Ulcer, Endoscopy, Case-controlled

Core tip: This study reports the incidence and clinical features of gastrointestinal (GI) involvement in a total of 168 consecutive Chinese patients with Behcet’s disease (BD), of whom upper and lower GI endoscopies were performed in 148 patients. Controls were enrolled for comparison. Fifty-two (35.1%) patients had GI lesions. After a mean follow-up of 10 mo, ileocecal ulcers had been confirmed in 20 patients, but no ileocecal ulceration was found in controls. Four patients had esophageal ulcers in the BD group but no case in controls. The other endoscopic findings were similar between the two groups.