Behçet's disease with intestinal involvement: case-based review

Mostbauer, G. V.; Karasevska, T.; Tsaralunga, Vira M.; Yurchenko, Alla V.; Ivashkivsky, O.

doi:10.1007/s00296-022-05152-x

Cited by 5 publications

(3 citation statements)

References 28 publications

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“…Gastrointestinal biopsy specimens are the most common tissues used for pathological assessment. Obvious vasculitis is the most common feature of BD [ 12 , 13 ]. Therefore, a detailed history, clinical features, and pathological assessment have important diagnostic value.…”

Section: Discussionmentioning

confidence: 99%

Behçet's disease with intestinal involvement: a case report and review of the literature

Li,

Wang,

et al. 2023

J Med Case Reports

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Background Behçet’s disease (BD) is a chronic systemic disease characterized by vasculitis as the basic pathological change. BD is rare, and gastrointestinal involvement occurs in 3% to 25% of affected patients. This article describes a rare case of intestinal BD along with a literature review of intestinal involvement in BD. Case presentation A 50-year-old Han woman from China presented with a > 6-month history of distending pain in the right upper abdomen. Because of mechanical obstruction secondary to stricture formation from an ileocecal ulcer, she underwent radical right colon resection, and postoperative pathologic examination indicated an ileocecal ulcer. The patient was readmitted to the hospital 6 months postoperatively for recurrence of the same symptoms. Colonoscopy indicated obvious narrowing of the anastomosis with an oval-shaped deep ulcer that could not be passed by the endoscope. Pathologic examination showed acute and chronic inflammation of the anastomotic mucosa and granulation tissue. In addition, gastroscopy showed a 3.0- × 4.0-cm giant ulcer at the junction of the descending bulb along with a sinus tract. Moreover, total gastrointestinal computed tomography angiography showed significant thickening of the intestinal wall near the transverse colon, forming a sinus tract at the junction of the antrum and duodenum with a length of about 1.3 cm and width of about 0.2 cm. Further inquiry regarding the patient’s medical history revealed that she had developed repeated oral ulcers 3 years previously and repeated eye inflammation 5 years previously. Specimens of the right half of the colon removed 6 months previously were sent to Run Run Shaw Hospital Affiliated to Zhejiang University for consultation. The pathologic examination revealed vasculitis in the submucosa and subserosa, and the patient was finally diagnosed with BD. She began treatment with adalimumab, and repeat gastroenteroscopy revealed that the intestinal ulcer had significantly improved. Conclusions An oval-shaped deep intestinal ulcer is a characteristic lesion in patients with BD and may involve the intestinal muscle layer. This case emphasizes that BD is a vasculitis affecting multiple organs and can present with a single, deep, clean-edged intestinal ulcer that penetrates the bowel wall to form a sinus tract. Therefore, careful examination and differential diagnosis should be carried out to prevent a poor prognosis. Adalimumab is effective for patients with intestinal BD.

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Section: Discussionmentioning

confidence: 99%

Behçet's disease with intestinal involvement: a case report and review of the literature

Li,

Wang,

et al. 2023

J Med Case Reports

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“…22 , 23 However, it can affect almost all organs and systems. 3 , 24 - 26 In addition to the classical triad, dermatological, musculoskeletal, pulmonary, cardiovascular, gastrointestinal, and nervous system involvements were reported. 27 …”

Section: Introductionmentioning

confidence: 99%

Vitamin D in Behcet’s Disease, a Brief Review of the Literature

Melikoğlu¹,

Sahin²,

Melikoğlu³

2023

Eurasian J Med

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Behcet’s disease is a chronic vasculitis of unknown etiopathogenesis. Serum vitamin D levels have been reported to be associated with a variety of inflammatory and autoimmune diseases one of which is Behcet’s disease. The previous studies about vitamin D in Behcet’s disease seem to be focused on 4 main categories; the studies evaluating serum vitamin D levels between patients with Behcet’s disease and controls, the studies evaluating serum vitamin D in the susceptibility and pathogenesis of Behcet’s disease, the studies evaluating serum vitamin D in clinical involvements and activity of Behcet’s disease, and the studies evaluating the effect of serum vitamin D replacement in Behcet’s disease. The aim of this manuscript was to evaluate the results of the studies on serum vitamin D in Behcet’s disease and review the literature.

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“…Oral mucosal diseases are characterised by their high incidence and wide extent of involvement. For example, the prevalence of recurrent aphthous ulcer (RAU) ranges from 5 to 25% [ 1 ], and the associated Behcet’s disease might involve other body sites besides the oral mucosa [ 2 ]; thus, oral mucosal lesions may serve as an indicator of systemic diseases. Erosions or ulcers are common manifestations and basic lesions of oral mucosal diseases, with erosions histologically presenting as partial defects of the mucosal epithelium and ulcers as defects of the entire epithelial layer.…”

Section: Introductionmentioning

confidence: 99%

Follicular lymphoma manifests as multiple erosive and proliferative lesions of the oral mucosa: case report and brief literature review

Zhang

et al. 2022

BMC Oral Health

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Background Erosion is one of the most common and basic lesions of oral mucosal diseases. Long-term refractory oral erosions, induced by autoimmune blistering diseases, infectious diseases, malignant diseases, and some rare conditions, may substantially reduce the quality of life of patients or even constitute a life-threatening condition, resulting in a clinical dilemma regarding the accurate diagnosis and precise management of these diseases. As a special type of malignant lymphoma, most lesions of follicular lymphoma (FL) in the oral mucosa present as masses or swelling of the oral mucosa, while emerging novel presentations lead to intractable diagnoses. Hence, diagnostic algorithms for such diseases are clinically required. Case presentation A 55-year-old female patient presented to the clinic with long-lasting oral mucosal erosions and proliferative lesions. Blood tests, pathological examinations of oral lesions including haematoxylin–eosin (HE) staining, and direct immunofluorescence precluded all of the potential diagnoses described previously. Unexpectedly, positron emission tomography/computed tomography (PET/CT) and abdominal CT of the patient revealed a dense mass in the retroperitoneal area, and the final diagnosis of the retroperitoneal mass was FL. After three courses of chemotherapy conducted by the haematologist, the erosion and proliferative lesions in the patient's oral mucosa had significantly improved. HE and immunohistochemical staining results of intraoral lesions also confirmed it as oral FL. The successful diagnosis of FL in this case is of great clinical significance, as the oral and abdominal FL were treated in a timely manner to avoid unfavourable outcomes. Conclusions To the best of our knowledge, this is the first case of FL that exhibited widespread erosions interspersed with proliferative lesions. Clinicians should be aware of oral FL or seek systemic factors in the presence of similar refractory oral erosions when treatment is non-responsive and the diagnosis is intractable.

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Behçet's disease with intestinal involvement: case-based review

Cited by 5 publications

References 28 publications

Behçet's disease with intestinal involvement: a case report and review of the literature

Behçet's disease with intestinal involvement: a case report and review of the literature

Vitamin D in Behcet’s Disease, a Brief Review of the Literature

Follicular lymphoma manifests as multiple erosive and proliferative lesions of the oral mucosa: case report and brief literature review

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