title: [Morbus Behçet or inflammatory bowel disease--a diagnostic and therapeutic dilemma].
abstract: We present the case of a 43-year old caucasian male suffering from a condition initially diagnosed as colitis ulcerosa. For 2 years Azathioprine and anti-TNF-alpha antibodies were used for treatment without convincing benefit but with serious adverse events. After the first occurrence of complex accompanying symptoms like oral and scrotal ulcerations, arthritis and scratch-induced skin lesions the differential diagnosis of a Morbus Adamantiades-Behçet with intestinal evolvement was considered. After introduction of a parenteral Ciclosporin medication, which was later switched to Tacrolimus and Azathioprin, a remission could be achieved that lasted for several months. When a drug-induced acute kidney injury occurred, the regime was changed to Golimumab and a delayed but significant improvement was achieved. To separate Morbus Adamantiades-Behçet from inflammatory bowel disease is of some difficulty, demands interdisciplinary cooperation and is the basis for a successful therapy.
authors.affiliation: Gastroenterologie, Hepatologie und Infektologie, Friedrich-Schiller-Universität, Jena, Germany.
authors.forename: S
authors.initials: S
authors.lastname: Schack
authors.affiliation: Gastroenterologie, Hepatologie und Infektologie, Friedrich-Schiller-Universität, Jena, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Weber
authors.affiliation: Nephrologie, Rheumatologie und Diabetologie, Friedrich-Schiller-Universität, Jena, Germany.
authors.forename: P
authors.initials: P
authors.lastname: Oelzner
authors.affiliation: Institut für Pathologie, Friedrich-Schiller-Universität, Jena, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Mireskandari
authors.affiliation: Klinik für Hautkrankheiten, Friedrich-Schiller-Universität, Jena, Germany.
authors.forename: D
authors.initials: D
authors.lastname: Antonov
authors.affiliation: Gastroenterologie, Hepatologie und Infektologie, Friedrich-Schiller-Universität, Jena, Germany.
authors.forename: A
authors.initials: A
authors.lastname: Stallmach
mesh_terms: D000328:Adult; D001528:Behcet Syndrome / Q000175:diagnosis* / Q000628:therapy*; D000066491:Clinical Decision-Making / Q000379:methods; D003937:Diagnosis, Differential; D005765:Gastrointestinal Agents / Q000008:administration & dosage*; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000175:diagnosis* / Q000628:therapy*; D008297:Male; D063189:Symptom Assessment / Q000379:methods*; D016896:Treatment Outcome
chemical_list: D005765:Gastrointestinal Agents