Intestinal Behçet and Crohn’s disease: two sides of the same coin

Abstract

Behçet’s disease (BD) and Crohn’s disease (CD) are chronic immune-mediated, inflammatory disorders affecting many different systems (joints, skin, eyes, gastrointestinal and biliary tracts). Both disorders have fluctuating courses and when gastrointestinal symptoms are prevalent, differential diagnosis can be difficult. BD involves the gastrointestinal tract in 10–15% of cases with localized lesions in the ileocecal region. The clinical picture is heterogeneous with various clusters of disease expression. CD is a chronic inflammatory disorder, which can affect any part of the intestinal tract, as well as extra-intestinal tissue. Factors that contribute towards the pathogenesis of both disease include the host’s genetic profile, and immune system, and environmental factors such as the gut microbiota. The aim of this manuscript is to provide a narrative review of clinical features of BD and CD, highlighting the importance of differential diagnosis and therapeutic approach, especially in the presence of gastrointestinal involvement. A comprehensive search of published literature using the Pubmed (http://www.ncbi.nlm.nih.gov/pubmed/) database was carried out to identify all articles published in English from 1999 to October 2016, using 4 key terms: “Behçet Disease”, “Intestinal Behçet’s Disease”, “Crohn’s Disease” and” Inflammatory Bowel Disease”.

Risk Factors and Outcomes of Emergency Room Visits in Intestinal Behçet’s Disease

“…Intestinal BD, which has similar pathogenesis and clinical feature to IBD, tends to occur more prevalently in East Asian countries than in the Western or Mediterranean regions [16, 17]. It is a chronic and often progressive disease, and therefore, many patients will require hospitalization or surgery in their lifetime [18].…”

A Case of Intra-Oral Bone Exposure of the Hard Palate: A Clinical Diagnostic Dilemma

“…Clinical investigations were also performed with the aim to reconsider the initial diagnosis of Crohn's disease. Indeed, HLA-B51 positivity is strongly related to Behcet's Disease [5] and when the gastrointestinal tract is involved, a differential diagnosis between Behcet's Disease and Crohn's Disease may be very difficult [6]. Clinical systemic investigations revealed multiple ulcers in ipo-pharingeal and laryngeal tract and a painful purulent ulceration on the skin, diagnosed as Pyoderma gangrenosum.…”

An unusual cause of granulomatous colitis: Behcet's disease

“…Behcet's disease (BD) is a chronic, multisystem, inflammatory disorder with an underlying vasculitic process. It shares many common features with Crohn's disease (CD), and these have even been considered two sides of the same coin . Differentiating between the two is important because the management of BD, although similar to CD, is not essentially the same .…”

“…It shares many common features with Crohn's disease (CD), and these have even been considered two sides of the same coin. 1 Differentiating between the two is important because the management of BD, although similar to CD, is not essentially the same. 2,3 BD with no gastrointestinal complaints may suggest pathological evidence of gut inflammation preceding clinical manifestation.…”