Long-term clinical course and prognostic factors in intestinal Behçet's disease.
OBJECTIVE
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.
Choi
I J
IJ
Department of Internal Medicine, Seoul National University College of Medicine, Korea.
Kim
J S
JS
Cha
S D
SD
Jung
H C
HC
Park
J G
JG
Song
I S
IS
Kim
C Y
CY
D000293:Adolescent; D000328:Adult; D001379:Azathioprine / Q000008:administration & dosage / Q000009:adverse effects; D001528:Behcet Syndrome / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D003082:Colectomy; D003108:Colonic Diseases / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D003113:Colonoscopy; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000009:adverse effects; D007412:Intestinal Fistula / Q000175:diagnosis / Q000473:pathology / Q000601:surgery; D007413:Intestinal Mucosa / Q000473:pathology; D007416:Intestinal Perforation / Q000175:diagnosis / Q000473:pathology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012086:Reoperation; D012189:Retrospective Studies
D007166:Immunosuppressive Agents; D001379:Azathioprine