It can be hard to distinguish between the GI complications of Behcet's disease and problems that may be due to ulcerative colitis, Crohn's disease, celiac disease, or irritable bowel syndrome. Here are some articles and letters that you may want to share with your doctors. I've included links to free PDFs for eight of the articles; the remaining references are linked to their abstracts (your doctors will be able to get the full articles).
1) Endoscopy. 2009 Jan;41(1):9-16. Epub 2009 Jan 21.
Differential diagnosis of intestinal Behçet's disease and Crohn's disease by colonoscopic findings.
http://www.ncbi.nlm.nih.gov/pubmed/19160153
Lee SK, Kim BK, Kim TI, Kim WH.
Excerpt: "It was determined that round and longitudinal ulcers are suggestive of Behçet's disease and Crohn's disease, respectively. Irregular/geographic-shaped ulcers and focal distributions are suggestive of Behçet's disease, while segmental/diffuse lesions suggest Crohn's."
PMID: 19160153
2) J Gastrointestin Liver Dis. 2008 Dec;17(4):481-3.
Concomitant colitis in a patient with Behcet's disease.
Full article for free at:
http://www.jgld.ro/42008/42008_20.pdf (Scroll to page 3)
Yilmaz Y, Dolar E.
Department of Internal Medicine, Uludag University School of Medicine, Uludag University Hospital, Bursa, Turkey.
Publication Types: Letter
PMID: 19104718
3) Am J Gastroenterol. 2008 Dec;103(12):3213-4.
Mycophenolate sodium: effective treatment for therapy-refractory intestinal Behçet's disease, evaluated with enteroscopy
Full article for free at:
http://www.nature.com/ajg/journal/v103/n12/pdf/ajg2008653a.pdf (Scroll to page 9)
Kappen JH, Mensink PB, Lesterhuis W, Lachman S, van Daele PL, van Hagen PM, van Laar JA.
Publication Types: Case Reports, Letter
PMID: 19086980
4) World J Gastroenterol. 2008 Dec 21;14(47):7271.
Differentiation of Behcet's disease from inflammatory bowel diseases: Anti-saccharomyces cerevisiae antibody and anti-neutrophilic cytoplasmic antibody.
http://www.wjgnet.com/1007-9327/14/7271.pdf
Filik L, Biyikoglu I.
Gastroenterology Division, Ankara Research Hospital, Ziya Gokalp Cad. Isik Apt.72-14 Kizilay, Ankara 06600, Turkey.eventfilik@yahoo.co.uk.
PMID: 19084948
5) World J Gastroenterol. 2008 Nov 14;14(42):6578-80.
Colonic perforation in Behcet's syndrome.
Full article for free at:
http://www.wjgnet.com/1007-9327/14/6578.pdf
Dowling CM, Hill AD, Malone C, Sheehan JJ, Tormey S, Sheahan K, McDermott E, O'Higgins NJ.
Department of Surgery, St. Vincents University Hospital, Elm Park, Dublin 4, Ireland. kathdowling@hotmail.com.
PMID: 19030217
6) Clin Exp Rheumatol. 2008 Jul-Aug;26(4 Suppl 50):S91-5.
Frequency of pathergy phenomenon and other features of Behçet's syndrome among patients with inflammatory bowel disease.
http://www.ncbi.nlm.nih.gov/pubmed/19026122
Hatemi I, Hatemi G, Celik AF, Melikoglu M, Arzuhal N, Mat C, Ozyazgan Y, Yazici H.
Division of Gastroenterology, Department of Internal Medicine, Cerrahpasa Medical School, Istanbul University, Istanbul, Turkey.
Excerpt: "Despite similarities between the clinical features of CD [Crohn's disease] and UC [ulcerative colitis] with BS [Behcet's syndrome], coexistence is uncommon. ISG [Behcet's International Study Group] criteria perform well in differentiating these diseases. About 8% of IBD [inflammatory bowel disease] patients show the pathergy phenomenon."
PMID: 19026122
7) Dig Dis Sci. 2008 Nov 7. [Epub ahead of print]
Prevalence of Celiac Disease Among Patients with Behcet's Disease in Iran.
http://www.ncbi.nlm.nih.gov/pubmed/18989774
Zamani F, Shahram F, Shakeri R, Zayyeni H, Davatchi F, Amiri A, Malekzadeh R.
Gastrointestinal and Liver Disease Research Center, Iran University of Medical Sciences, Tehran, Iran.
PMID: 18989774
8) Rheumatol Int. 2008 Sep 26. [Epub ahead of print]
Behçet's disease: clinical value of the video capsule endoscopy for small intestine examination.
http://www.ncbi.nlm.nih.gov/pubmed/18818923
Neves FS, Fylyk SN, Lage LV, Ishioka S, Goldenstein-Schainberg C, Sakai P, Gonçalves CR.
Rheumatology Unit, University of São Paulo, Av. Dr. Arnaldo 455, 3 andar, sala 3133, Pacaembu, São Paulo, SP, CEP 01246-903, Brazil, nevesfab@bol.com.br.
PMID: 18818923
9) Ann Rheum Dis. 2002 May;61(5): 459-62.
Humoral and cell mediated immune response to cow's milk proteins in Behcet's disease.
Full article for free at:
http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pubmed&pubmedid=11959773
Triolo G, Accardo-Palumbo A, Dieli F, Ciccia F, Ferrante A, Giardina E, Licata G.
10) AJR Am J Roentgenol. 1994 Feb;162(2):349-50
CT evaluation of the gastrointestinal tract in a patient with Behcet's syndrome.
Full article for free at:
http://www.ajronline.org/cgi/reprint/162/2/349
Johnson WK, Beierle E, Ros PR
PMID: 8310925
11) Abdom Imaging. 2001 May-Jun;26(3):309-14.
Intestinal Behcet's disease: breath-hold MR imaging.
http://www.ncbi.nlm.nih.gov/pubmed/11429961
You JK, Kim MJ, Park S, Chung JJ, Kim WH
PMID: 11429961
12) Radiographics. 2001 Jul-Aug;21(4):911-24; discussion 924-6
(This is one of my most-recommended articles -- good pictures)
Radiologic findings of Behcet syndrome involving the gastrointestinal tract.
Full article for free at:
http://pubs.rsna.org/doi/pdf/10.1148/radiographics.21.4.g01jl19911
Chung SY, Ha HK, Kim JH, Kim KW, Cho N et al.
PMID: 11452065
13) Inflamm Bowel Dis. 2008 Mar;14(3):396-400.
Thalidomide for treatment of intestinal involvement of juvenile-onset Behcet disease.
http://www.ncbi.nlm.nih.gov/pubmed/17973303
Yasui K, Uchida N, Akazawa Y, et al.
PMID: 17973303
14) Eur J Pediatr. 2005 Aug;164(8):523-5. Epub 2005 Apr 23.
Intestinal Behcet disease presenting as neonatal onset chronic diarrhea in an 11-month-old male baby. (No abstract available)
PMID: 15856294
15) Blood. 2004 Jan 15;103(2):748-50
Autologous hematopoietic stem cell transplantation for severe/refractory intestinal Behcet disease.
Full article for free at:
http://bloodjournal.hematologylibrary.org/cgi/reprint/103/2/748
Rossi G, Moretta A, Locatelli F. PMID: 14702292
16) Radiology. 1998 Nov;209(2): 449-54.
Intestinal Behcet syndrome: CT features of patients with and patients without complications.
Full article for free at:
http://radiology.rsnajnls.org/cgi/reprint/209/2/449
Ha HK, Lee HJ, Yang SK et al.
PMID: 9807572MID: 8310925
Thank you so much for the comment you left on my blog yesterday. I have no idea how you found me, but knowing that there is someone else out there who knows exactly what I'm going through and who understands, means a lot to me. I've been searching for a diagnosis for 8 years now, and I can't imagine having to endure for another 8. You're an amazingly strong person and thank you for showing me that it's possible to make it through these things without losing your mind! There is hope. There is always hope.
ReplyDeleteAmanda