title: Correlations between endoscopic and clinical disease activity indices in intestinal Behcet's disease.
abstract: OBJECTIVE
  To develop a novel endoscopic severity model of intestinal Behcet's disease (BD) and to evaluate its feasibility by comparing it with the actual disease activity index for intestinal Behcet's disease (DAIBD).
  
  
  METHODS
  We reviewed the medical records of 167 intestinal BD patients between March 1986 and April 2011. We also investigated the endoscopic parameters including ulcer locations, distribution, number, depth, shape, size and margin to identify independent factors associated with DAIBD. An endoscopic severity model was developed using significant colonoscopic variables identified by multivariate regression analysis and its correlation with the DAIBD was evaluated. To determine factors related to the discrepancy between endoscopic severity and clinical activity, clinical characteristics and laboratory markers of the patients were analyzed.
  
  
  RESULTS
  A multivariate regression analysis revealed that the number of intestinal ulcers (≥ 2, P = 0.031) and volcanoshaped ulcers (P = 0.001) were predictive factors for the DAIBD. An endoscopic severity model (Y) was developed based on selected endoscopic variables as follows: Y = 47.44 + 9.04 × non-Ileocecal area + 11.85 × ≥ 2 of intestinal ulcers + 5.03 × shallow ulcers + 12.76 × deep ulcers + 4.47 × geographic-shaped ulcers + 26.93 × volcano-shaped ulcers + 8.65 × ≥ 20 mm of intestinal ulcers. However, endoscopic parameters used in the multivariate analysis explained only 18.9% of the DAIBD variance. Patients with severe DAIBD scores but with moderately predicted disease activity by the endoscopic severity model had more symptoms of irritable bowel syndrome (21.4% vs 4.9%, P = 0.026) and a lower rate of corticosteroid use (50.0% vs 75.6%, P = 0.016) than those with severe DAIBD scores and accurately predicted disease by the model.
  
  
  CONCLUSIONS
  Our study showed that the number of intestinal ulcers and volcano-shaped ulcers were predictive factors for severe DAIBD scores. However, the correlation between endoscopic severity and DAIBD (r = 0.434) was weak.
authors.affiliation: Department of Internal Medicine, Institute of Gastroenterology, Yonsei University College of Medicine, Seoul 120-752, South Korea.
authors.forename: Hyun Jung
authors.initials: HJ
authors.lastname: Lee
authors.forename: Youn Nam
authors.initials: YN
authors.lastname: Kim
authors.forename: Hui Won
authors.initials: HW
authors.lastname: Jang
authors.forename: Han Ho
authors.initials: HH
authors.lastname: Jeon
authors.forename: Eun Suk
authors.initials: ES
authors.lastname: Jung
authors.forename: Soo Jung
authors.initials: SJ
authors.lastname: Park
authors.forename: Sung Pil
authors.initials: SP
authors.lastname: Hong
authors.forename: Tae Il
authors.initials: TI
authors.lastname: Kim
authors.forename: Won Ho
authors.initials: WH
authors.lastname: Kim
authors.forename: Chung Mo
authors.initials: CM
authors.lastname: Nam
authors.forename: Jae Hee
authors.initials: JH
authors.lastname: Cheon
mesh_terms: D000328:Adult; D001528:Behcet Syndrome / Q000175:diagnosis* / Q000473:pathology; D016009:Chi-Square Distribution; D003106:Colon / Q000473:pathology; D003113:Colonoscopy; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007082:Ileum / Q000473:pathology; D007422:Intestines / Q000473:pathology*; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010437:Peptic Ulcer / Q000175:diagnosis* / Q000473:pathology; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012720:Severity of Illness Index