Long-term clinical course and prognostic factors in intestinal Behçet's disease.

Abstract

PURPOSE:

The present study was aimed at evaluating the long-term course of intestinal Behçet's disease and determining predictive factors of prognosis.

METHODS:

This report is a retrospective study based on the records of 43 patients with intestinal Behçet's disease. The mean follow-up duration was 73 +/- 60 months. We evaluated the efficacy of medical treatment for the intestinal lesion at initial eight weeks. The cumulative probabilities were calculated by using Kaplan-Meier method, and the results were compared by using the log-rank test.

RESULTS:

Sixteen patients (38 percent) achieved a complete remission of intestinal lesions eight weeks after medical treatment had begun. The patients who achieved a complete remission had a lower probability of receiving an operation than those who had not (13 percent at 2 and 5 years vs. 36 and 43 percent, respectively; P = 0.028). The recurrence probability of intestinal lesions was 25 percent at two years and 49 percent at five years after complete remission with medical treatment. Patients who had a history of intestinal perforation or fistula had a higher probability of recurrence after operation than those without such history (59 vs. 33 percent at 2 years; 88 vs. 57 percent at 5 years; P = 0.020). Patients who had taken azathioprine had a lower probability of receiving reoperation than those who did not (7 vs. 25 percent at 2 years; 25 vs. 47 percent at 5 years; P = 0.035). The length of ileal resection and whether hemicolectomy was performed had no significant effect on the recurrence or reoperation rate.

CONCLUSIONS:

Intestinal Behçet's disease frequently requires a surgical treatment and has a high recurrence rate. The patients who achieved a complete remission with medical treatment, who had no history of intestinal perforation, and who received azathioprine after operation showed better clinical courses. Resection of a short segment of bowel would be a more appropriate surgical procedure.

• Authors: I J Choi, J S Kim, S D Cha, H C Jung, J G Park, I S Song, C Y Kim
• Journal: Diseases of the colon and rectum (Dis Colon Rectum) Vol. 43 Issue 5 Pg. 692-700 (May 2000) ISSN: 0012-3706 [Print] United States
• PMID: 10826433 (Publication Type: Journal Article)

Chemical References

• Immunosuppressive Agents
• Azathioprine

Topics

• Adolescent
• Adult
• Azathioprine (administration & dosage, adverse effects)
• Behcet Syndrome (diagnosis, pathology, surgery)
• Colectomy
• Colonic Diseases (diagnosis, pathology, surgery)
• Colonoscopy
• Combined Modality Therapy
• Female
• Follow-Up Studies
• Humans
• Immunosuppressive Agents (administration & dosage, adverse effects)
• Intestinal Fistula (diagnosis, pathology, surgery)
• Intestinal Mucosa (pathology)
• Intestinal Perforation (diagnosis, pathology, surgery)
• Male
• Middle Aged
• Recurrence
• Reoperation
• Retrospective Studies