Clinical course of intestinal Behcet's disease during the first five years.
BACKGROUND
Little is known about the clinical course of patients with intestinal Behcet's disease (BD). We aimed to evaluate the clinical course of intestinal BD during the first 5 years after diagnosis, and to identify factors that could predict the 5-year clinical course.


METHODS
We reviewed the medical records of 130 intestinal BD patients who were regularly followed-up for at least 5 years at a single tertiary academic medical center between March 1986 and September 2011.


RESULTS
Of the five different clinical course patterns that we observed, persistent remission or mild clinical activity was the most frequent course (56.2 %). The majority of patients (74.6 %) had remission or mild clinical activity at 5 years, and only the minority (16.2 %) had multiple relapses or chronic symptoms. The clinical course of the first year after diagnosis of intestinal BD influenced the clinical course of the following years. Patients in the severe clinical course group were younger, and had a higher ESR, CRP level, and disease activity index for intestinal Behcet's disease (DAIBD), and lower albumin level at diagnosis than patients in the mild clinical course group. Initial presentation with a high DAIBD was independently associated with a severe clinical course.


CONCLUSIONS
The clinical course of intestinal BD during the first 5 years was variable. A substantial proportion of patients went into remission or had a mild clinical activity, while some patients had a severe, debilitating clinical course as time progressed. High disease activity at diagnosis was a negative prognostic predictor.
Division of Gastroenterology, Department of Internal Medicine, Yonsei University College of Medicine, 134 Shinchon-dong, Seodaemun-gu, Seoul, Korea.
Yoon Suk
YS
Jung
Jae Hee
JH
Cheon
Soo Jung
SJ
Park
Sung Pil
SP
Hong
Tae Il
TI
Kim
Won Ho
WH
Kim
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000328:Adult; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D001528:Behcet Syndrome / Q000188:drug therapy* / Q000401:mortality* / Q000601:surgery; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D005765:Gastrointestinal Agents / Q000627:therapeutic use*; D006801:Humans; D007410:Intestinal Diseases / Q000401:mortality*; D008297:Male; D019804:Mesalamine / Q000627:therapeutic use; D008875:Middle Aged; D015999:Multivariate Analysis; D011237:Predictive Value of Tests; D011379:Prognosis; D012008:Recurrence; D012074:Remission Induction; D012307:Risk Factors; D012720:Severity of Illness Index; D012460:Sulfasalazine / Q000627:therapeutic use
D000305:Adrenal Cortex Hormones; D000894:Anti-Inflammatory Agents, Non-Steroidal; D005765:Gastrointestinal Agents; D012460:Sulfasalazine; D019804:Mesalamine