Massive Hemorrhage in a Patient with Intestinal Behçet's Disease: Report of a Case

Fujita, Hideto; Kiriyama, Masato; Kawamura, Taiichi; Toru,; Takegawa, Shigeru; Dohba, Shotaro; Kojima, Yasuhiko; Adachi, Hiroshi; Morimoto, Hideo; Kobayashi, Akihiko; Watanabe, Kishichiro

doi:10.1007/s005950200057

Cited by 20 publications

(5 citation statements)

References 14 publications

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“…Of patients undergoing CT scanning, 82% had abdominal pain; 25% had weight loss; 18% had diarrhea, and 14% had melena or fever [19]. Perforation or penetration is common, but major gastrointestinal bleeding is rare [17,20,21].…”

Section: Gastrointestinal (Gi) Diseasementioning

confidence: 97%

Gastrointestinal Manifestations of Behçet’s Disease

Ebert

2008

Dig Dis Sci

113

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Behçet's disease is a rare vasculitis diagnosed by the presence of recurrent oral ulcers and two of the following: genital ulcers, typical eye lesions, typical skin lesions, and positive pathergy test. It is most commonly seen in countries along the ancient silk road from Eastern Asia to the Mediterranean Basin. Young adults between the second and fourth decades of life are mainly affected, with abdominal pain being the most common symptom. The ileocecal region is most commonly affected, with ulcerations that may penetrate or perforate. Rarely, the esophagus and stomach may have ulcerations. Bowel wall thickening is the most common finding on computed tomography (CT) scan. Pathology shows a vasculitis mainly involving the small veins or, alternatively, nonspecific inflammation. Corticosteroids, with or without other immunosuppressive drugs, are used for severe eye disease. Their use in intestinal disease is largely empirical. Surgery may be required for perforation. Behçet's disease runs a chronic, unpredictable course with exacerbations and remissions which decrease in frequency and severity over time. Death is mainly due to major vessel disease and neurological involvement.

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Section: Gastrointestinal (Gi) Diseasementioning

confidence: 97%

Gastrointestinal Manifestations of Behçet’s Disease

Ebert

2008

Dig Dis Sci

113

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“…Previous reports revealed several clinical characteristics such as a low prevalence rate of eye lesions and a high prevalence rate of intestinal lesions in BD patients with MDS involving trisomy 8 [14]. As shown in table 1, only 5.1% of BD patients with MDS involving trisomy 8 had eye lesions, whereas 74.4% had intestinal lesions [2,8,9,10,15,16,17,18,19,20,21,22,23,24,25,26,27,28,29,30,31,32,33,34]. These data showed a tendency similar to previous reports.…”

Section: Discussionmentioning

confidence: 99%

Refractoriness of Intestinal Behçet's Disease with Myelodysplastic Syndrome Involving Trisomy 8 to Medical Therapies - Our Case Experience and Review of the Literature

et al. 2013

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Background/Aims: Gastrointestinal lesions of Behçet's disease (BD) are often refractory to medical therapy and sometimes result in serious comorbidities such as gastrointestinal perforation and massive bleeding. There are several reports of patients with BD comorbid with myelodysplastic syndrome (MDS) involving trisomy 8 that frequently have intestinal lesions refractory to conventional medical therapy. Little is known about the efficacy of infliximab (IFX) for these intestinal lesions. Methods: We present 2 cases of intestinal BD with MDS involving trisomy 8 who did not respond to IFX, and review previous reports of BD with MDS involving trisomy 8 concerning their responsiveness to conventional medical therapy. Results: Among 31 previously reported cases that received medical treatment for BD, 19 (61.3%) showed temporary improvement of the BD symptoms, 9 (29.0%) deteriorated, and 3 (9.7%) showed no change. All of the 9 cases that showed deterioration had intestinal lesions. Our 2 cases failed to respond to IFX, resulting in a poor prognosis. Conclusions: IFX might not be effective for improving intestinal BD comorbid with MDS involving trisomy 8. Trisomy 8 is associated with the BD prognosis and refractoriness to conventional medical therapy.

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“…Corticosteroids, 5-aminosalicylic acid derivatives, immunomodulators, blood transfusions, thalidomide, pentoxifylline, and more recently, antitumor necrosis factor monoclonal antibody, have all been used to treat Behçet's disease with varying degrees of success. 3,11,21,22 Gastrointestinal involvement of Behçet's disease is relatively common and usually mild, although occasionally it manifests as a surgical emergency with bleeding or perforation. Thus, surgeons should be aware of these complications while evaluating patients with Behçet's disease.…”

Section: Discussionmentioning

confidence: 99%

Sigmoid Colon Perforation as an Unusual Complication of Beh�et's Syndrome: Report of a Case

Turan¹,

Şen²,

Koyuncu³

et al. 2003

Surgery Today

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A 47-year-old man with long-standing Behçet's syndrome presented with an acute abdomen, and was found to have perforation of the sigmoid colon. Laparotomy revealed gangrenous changes in the sigmoid colon and perforation in the center of the affected segment. This is a very rare complication of Behçet's disease, and we report this case to stress the importance of performing careful abdominal examination while evaluating patients with Behçet's disease.

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Massive Hemorrhage in a Patient with Intestinal Behçet's Disease: Report of a Case

Cited by 20 publications

References 14 publications

Gastrointestinal Manifestations of Behçet’s Disease

Gastrointestinal Manifestations of Behçet’s Disease

Refractoriness of Intestinal Behçet's Disease with Myelodysplastic Syndrome Involving Trisomy 8 to Medical Therapies - Our Case Experience and Review of the Literature

Sigmoid Colon Perforation as an Unusual Complication of Beh�et's Syndrome: Report of a Case

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