Clinical analysis of gastrointestinal involvement in Beh(c)et's disease: a study of 64 patients / 中华风湿病学杂志

ABSTRACT

Objective To investigate the clinic manifestations of intestinal involvement of Beh(c)et's disease (BD).Methods Medical data of patients with intestinal involvement of BD admitted to Peking Union Medical College Hospital (PUMCH) from January 1994 to August 2013 were retrospectively reviewed.Clinic manifestations,laboratory tests and endoscopic characteristics were analyzed,and the influence of sex on the clinic manifestations was investigated.Numerical data and categorical data comparisons were analyzed using t-test,x2 test respectively.Results Sixty-four patients with intestinal involvement accounted for 10.5 percent (64/611) of total hospitalized BD patients during the same period.Among these 64 patients,31 were male and 33 were female.The median age at the onset of intestinal involvement was 34 years old.Gastrointestinal symptoms were presented after other systemic symptoms of BD in 91％ patients (58/64).Abdominal pain (88％,56/64) was the most common clinical manifestations of intestinal involvement,and severe complications such as gastrointestinal bleeding (31％,20/64),intestinal obstruction (22％,14/64),intestinal perforation (11％,7/64) and intestinal fistula (16％,10/64) could also occur in some patients.Lesions usually located at ileocecum portion of the gastrointestinal tract.The common endoscopic manifestation was deep ulcers.Female sex was associated with higher C reactive protein level and lower serum albumin level [(52±46) vs (27±36) mg/L,t=2.287,P=0.026; Serum albumin(34±6) vs (37±5) mg/L,t=2.237,P=0.029].After treated with glucocorticoid,im-munosuppressant and TNF-α blockers,62 patients achieved clinical remission while 21 cases were operated.Conclusion Most of intestinal involvement of BD patients are young adults,and the gastrointestinal symp-toms usually present after the presence of other systemic symptoms.Abdominal pain is the most common manifestations,while severe complications such as gastrointestinal bleeding and intestinal obstruction can also occur.The most common endoscopic findings are deep ulcers,which often located in the ileocecal region.Female patients are more likely to have severe clinical course.Glucocorticoid,immunosup-pressant and TNF-α antagonist therapy are effective,but some patients still need surgical intervention.