Letters To The Editor Open Access
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World J Gastroenterol. Dec 21, 2008; 14(47): 7271-7271
Published online Dec 21, 2008. doi: 10.3748/wjg.14.7271
Differentiation of Behcet’s disease from inflammatory bowel diseases: Anti-saccharomyces cerevisiae antibody and anti-neutrophilic cytoplasmic antibody
Levent Filik, Ibrahim Biyikoglu
Levent Filik, Ibrahim Biyikoglu, Gastroenterology Division, Ankara Research Hospital, Ankara 06600, Turkey
Author contributions: Filik L designed the study, Filik L and Biyikoglu I performed the research, Filik L analyzed the data and wrote the paper.
Correspondence to: Dr. Levent Filik, Gastroenterology Division, Ankara Research Hospital, Ziya Gokalp Cad. Isik Apt. 72-14 Kizilay, Ankara 06600, Turkey. leventfilik@yahoo.co.uk
Telephone: +90-312-4335199 Fax: +90-312-5953376
Received: October 16, 2008
Revised: November 26, 2008
Accepted: December 3, 2008
Published online: December 21, 2008


The differential diagnosis of Behcet’s disease (BD) from inflammatory bowel disease (IBD) is sometimes difficult and challenging. Hereby, we suggested the utility of anti-saccharomyces cerevisiae antibody (ASCA) and anti-neutrophilic cytoplasmic antibody (p-ANCA) in the differential diagnosis of BD from IBD.

Key Words: Anti-neutrophilic cytoplasmic antibody, Anti-saccharomyces cerevisiae antibody, Behcet’s disease


The clinical diagnosis of Behcet's disease (BD) may pose considerable difficulties. Since the disease is multisystemic and does not have any pathognomonic symptom or laboratory findings, the diagnosis is based on a group of clinical features (oral, genital, skin or ocluar lesions)[1,2]. Gastrointestinal manifestation is relatively common in Japanese patients with BD (50%-60%), and the rate is significantly lower in Turkish and American population (5% and 8%, respectively)[3,4]. Similarly, accurate diagnosis of inflammatory bowel diseases (IBD) is very important. Also, because the treatment strategies in Crohn's disease (CD) and ulcerative colitis (UC) differ, especially when surgery is required, much effort has been expended over the years to distinguish some cases. Non-invasive tests are expected to display a crucial role in the differential diagnosis. The presence of a relatively specific laboratory marker can substantially facilitate the diagnosis of BD, and possibly support a diagnosis before all disease manifestations have occurred. Serum was obtained from 18 patients with BD whose diagnosis was fulfilled with the criteria of Behcet's Disease International Study Group[5]. Both anti-saccharomyces cerevisiae antibody (ASCA) and anti-neutrophilic cytoplasmic antibody (p-ANCA) were measured with indirect immunofluorescence assay. None of the patients was ASCA or p-ANCA positive.

ASCA is more frequently found in CD patients (50%-80%) compared to patients with UC (2%-14%)[6]. ANCA is present in the sera of 60%-80% of the patients with UC and approximately 10%-30% of patients with CD[6]. Since none of the patients in this study was ASCA or p-ANCA positive, we might conclude that both serologic tests may aid in the differential diagnosis of IBD and BD.


S- Editor Tian L L- Editor Ma JY E- Editor Ma WH

1.  Shimizu T, Ehrlich GE, Inaba G, Hayashi K. Behcet disease (Behcet syndrome). Semin Arthritis Rheum. 1979;8:223-260.  [PubMed]  [DOI]  [Cited in This Article: ]
2.  Rhee SH, Kim YB, Lee ES. Comparison of Behcet's disease and recurrent aphthous ulcer according to characteristics of gastrointestinal symptoms. J Korean Med Sci. 2005;20:971-976.  [PubMed]  [DOI]  [Cited in This Article: ]
3.  Yurdakul S, Tuzuner N, Yurdakul I, Hamuryudan V, Yazici H. Gastrointestinal involvement in Behcet's syndrome: a controlled study. Ann Rheum Dis. 1996;55:208-210.  [PubMed]  [DOI]  [Cited in This Article: ]
4.  Balabanova M, Calamia KT, Perniciaro C, O'Duffy JD. A study of the cutaneous manifestations of Behcet's disease in patients from the United States. J Am Acad Dermatol. 1999;41:540-545.  [PubMed]  [DOI]  [Cited in This Article: ]
5.  Criteria for diagnosis of Behcet's disease. International Study Group for Behcet's Disease. Lancet. 1990;335:1078-1080.  [PubMed]  [DOI]  [Cited in This Article: ]
6.  Papp M, Norman GL, Altorjay I, Lakatos PL. Utility of serological markers in inflammatory bowel diseases: gadget or magic? World J Gastroenterol. 2007;13:2028-2036.  [PubMed]  [DOI]  [Cited in This Article: ]