Behçet syndrome and Crohn’s disease – what are the differences?

Baptista, Bernardo; Marto, Natália; Tavares, João Galaz; Horta, Alexandra Bayão; Sá, Diogo Cunha e; Gerardo, Gonçalo; Mafra, Manuela

doi:10.12890/2019_001044

Cited by 4 publications

(4 citation statements)

References 5 publications

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“…Behçet's disease (BD) is a chronic multisystem variable vessel vasculitis 1 and tends to be more severe in men 2 . A high prevalence is reported in countries along the ancient silk road, stretching from Asia to the Mediterranean countries, but is not confined to these geographic locations 3 . Ocular, vascular, and central nervous system (CNS) involvements are the major causes of BD morbidity and mortality 2 .…”

Section: Introductionmentioning

confidence: 99%

Development and validation of a Behçet's Disease Damage Index for adults with BD: An Explicit, Composite and Rated (ECR) tool

et al. 2021

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Background Behçet's disease (BD) is a chronic multisystem variable vessel vasculitis. Disease damage is irreversible and permanent. Validated tools evaluating damage are limited. Enhancements in the clinical treatment of vasculitis will take place from the development of refined and exclusive indices for individual vasculitic syndromes including BD and attempting their international validation. Objectives This aim was to develop and validate a simple BD Damage Index (BDI). Methods This was a nationwide study including 1252 BD patients. The work consisted of 3 stages. Stage 1: items generation for score content. Stage 2: items selection for the draft score was performed by an expert rheumatologist. Stage 3: the content validity of the draft score was assessed and BDI, Vasculitis Damage Index (VDI), Antineutrophil cytoplasmic antibody‐associated Vasculitis Index of Damage (AVID) and Combined Damage Assessment Index (CDAI) were calculated and compared. Results The mean age of the BD patients was 36.1 ± 9.9 years. Stages 1 and 2 resulted in a BDI instrument containing 73 items with a maximum score of 100. Stage 3, the VDI, CDAI, AVID, and BDI were 2.9 ± 2.2, 3.1 ± 2.3, 3.1 ± 2.3 and 5.1 ± 2.9, respectively. High correlations (r = .9) between comparable damage scores assured acceptable concurrent validity. Conclusion The proposed BDI represents a new robust and potentially useful tool when dealing with BD chronic status.

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Section: Introductionmentioning

confidence: 99%

Development and validation of a Behçet's Disease Damage Index for adults with BD: An Explicit, Composite and Rated (ECR) tool

et al. 2021

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“…It is challenging to make a differential diagnosis between intestinal BD and CD at early presentation because these two diseases share many similarities. 1,10,19 Studies on the comparison of pathological characteristics of GI biopsy specimens between BD and CD are scarce, and intestinal biopsies have not been systematically analyzed, especially in patients with ileocecal ulcers. In a study on upper GI biopsy specimens from 50 CD patients and 34 BD patients, Akemoto et al found that in H. pylori-negative patients, focal gastric neutrophilic infiltration and wide duodenal gastric foveolar metaplasia were important in distinguishing CD from BD.…”

Section: Discussionmentioning

confidence: 99%

“…It is challenging to make a differential diagnosis between intestinal BD and CD at early presentation because these two diseases share many similarities 1,10,19 . Studies on the comparison of pathological characteristics of GI biopsy specimens between BD and CD are scarce, and intestinal biopsies have not been systematically analyzed, especially in patients with ileocecal ulcers.…”

Section: Discussionmentioning

confidence: 99%

Ileocecal involvement in intestinal Behçet's disease and Crohn's disease: comparison of clinicopathological and immunophenotypic features

Wu,

Fu,

Xia

et al. 2023

J of Digest Diseases

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BackgroundIntestinal Behcet's disease (BD) predominantly affects the ileocecal region and is currently diagnosed based on endoscopic features and clinical manifestations. It is difficult to distinguish between BD and Crohn's disease (CD) due to the similar patients' population, gastrointestinal involvement, extraintestinal presentation, and long recurrent course. We performed a study to compare the clinicopathological and immunophenotypic features of intestinal BD to CD.MethodsThe medical and pathological records of 29 cases of intestinal BD and 120 cases of CD diagnosed at Sir Run Run Shaw Hospital were retrospectively analyzed. Immunohistochemistry for CD3, CD20, FOXP3, myeloperoxidase, and quantitative analysis of the infiltrating inflammatory cells was conducted.ResultsIntestinal BD with ileocecal ulcer had a greater incidence of abdominal pain and a higher mean erythrocyte sedimentation rate value than CD, while CD had a significantly higher incidence of chronic diarrhea. Excessive neutrophils in the mucosal lamina propria, neutrophilic exudate on the ulcer surface, and prominent lymphocytic infiltration in ulcer tissue were statistically more frequent in intestinal BD than in CD. The number of FOXP3+ T cells, CD3+ T cells, and CD20+ B cells in biopsy tissue from intestinal BD were significantly higher than CD, but the ratio of FOXP3+/CD3+ T cells was not statistically different.ConclusionBesides the typical clinical and endoscopic findings, diagnostic biopsies from the ileocecal region in intestinal BD show some histological and immunophenotypic features that are different from CD which may be useful in distinguishing these two entities.This article is protected by copyright. All rights reserved.

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“…A study has reported that the thrombosis prevalence among patients with CD is 5.7% ( 20 ). In addition, BD is frequently misdiagnosed as CD in adults ( 21 ). Overall, CD has many features that overlap with BD, and as our case shows, distinguishing between these two conditions can be challenging.…”

Section: Discussionmentioning

confidence: 99%

The Twists and Turns of Diagnosis and Treatment of Pediatric Neuro-Behcet's Disease: A Case Report and Literature Review

et al. 2021

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Background: The neurological manifestation of Behcet's disease (BD) is known as Neuro-Behcet's disease (NBD). The lack of a specific diagnostic method for NBD renders the diagnosis and treatment of NBD challenging.Methods and Results: We report a boy aged 11 years and 11 months who underwent right-eye intraocular lens implantation, appendectomy, perianal abscess removal, thalidomide therapy, and infliximab infusions for his Crohn disease. Magnetic resonance venography (MRV) and magnetic resonance imaging (MRI) were performed to address the onset of headache during the course of his treatment, and cerebral venous sinus thrombosis was detected. After the diagnosis of NBD, the patient was treated with anticoagulation therapy (nadroparin calcium), low-dose corticosteroids, and an immunosuppressant (cyclophosphamide), and consequently, he recovered.Conclusion: This case report shows that NBD is prone to misdiagnosis and missed diagnosis and should be diagnosed based on clinical manifestations and results from colonoscopy, pathological examination, and MRI or MRV.

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Behçet syndrome and Crohn’s disease – what are the differences?

Cited by 4 publications

References 5 publications

Development and validation of a Behçet's Disease Damage Index for adults with BD: An Explicit, Composite and Rated (ECR) tool

Development and validation of a Behçet's Disease Damage Index for adults with BD: An Explicit, Composite and Rated (ECR) tool

Ileocecal involvement in intestinal Behçet's disease and Crohn's disease: comparison of clinicopathological and immunophenotypic features

The Twists and Turns of Diagnosis and Treatment of Pediatric Neuro-Behcet's Disease: A Case Report and Literature Review

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