Prediction of the Clinical Course of Behçet's Colitis According to Macroscopic Classification by Colonoscopy

Js, Kim; Lim, Samsung; Ij, Choi; Moon, Hong Ju; Hc, Jung; Song, In‐Uk; Cy, Kim

doi:10.1055/s-2000-9012

Cited by 59 publications

(49 citation statements)

References 12 publications

(15 reference statements)

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“…These results are consistent with those of several other studies. Kim et al 13 indicated that volcano-type ulcerations in intestinal BD demonstrated a significantly lower remission rate with medical treatment, a higher cumulative surgery rate, and higher recurrence rate. Chung et al 18 reported that volcano-type ulcers in intestinal BD patients who received medical treatment predicted higher cumulative recurrence and surgery rates.…”

Section: Discussionmentioning

confidence: 98%

“…Relapse was defined as a recurrence of intestinal symptoms, reappearance of ulcers at the anastomosis site, or the development of new ulcers detected by colonoscopy or radiological examinations following surgery. 13 Reoperation was defined as a surgical treatment related to intestinal BD following the initial operation. This study was approved by the Institutional Review Board of Severance Hospital, Seoul, Korea.…”

Section: Definitions Of Variablesmentioning

confidence: 99%

See 1 more Smart Citation

Prognostic factors and long-term clinical outcomes for surgical patients with intestinal Behcetʼs disease

Jung

Yoon

Lee

et al. 2011

Inflammatory Bowel Diseases

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Section: Discussionmentioning

confidence: 98%

Section: Definitions Of Variablesmentioning

confidence: 99%

Prognostic factors and long-term clinical outcomes for surgical patients with intestinal Behcetʼs disease

Jung

Yoon

Lee

et al. 2011

Inflammatory Bowel Diseases

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“…Macro- and microscopic features of colonic involvement of BD have been relatively well defined [1,5,6]. In a previous study reported from Turkey [8], although there was no macroscopic ulceration in the resected colons, there was evidence of focal colitis including crypt abscess, submucosal fibrosis and an inflammatory reaction with intact mucosa in histological analysis.…”

Section: Discussionmentioning

confidence: 99%

“…Since endoscopic investigations are usually performed in clinically symptomatic cases in BD, the exact prevalence of GI tract involvement in BD is unknown. There are several descriptions about the endoscopic characteristics of intestinal BD [1,4,5,6]. Most of the studies have reported the macro- and microscopic features of colonic lesions at colonoscopy [5,6], whereas lesions of the small intestine have only been defined in cases with perforated intestine.…”

Section: Introductionmentioning

confidence: 99%

Ileocolonic Involvement in Behçet’s Disease: Endoscopic and Histological Evaluation

et al. 2010

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Background: Our aim was to document the frequency of gastrointestinal (GI) involvement of Behçet’s disease (BD) at endoscopic examination. Also, we aimed to analyze whether GI lesions were correlated with other systemic components of BD. Methods: Fifty patients with BD were enrolled in the study. Patients in whom optimal colonoscopic examination of both the colon and terminal ileum could be performed were included. An ileum biopsy was taken from all cases. Upper GI endoscopy findings, presence of genital ulcers, uveitis, dermatological lesions, pathergy test, neurological involvement and peripheral vasculitis, and laboratory findings were recorded. Thirty age- and sex-matched persons who had perfect bowel cleansing and had a macroscopically normal colon and terminal ileum at colonoscopy without any systemic diseases were enrolled as the control group. Results: Nine patients and 1 case had macroscopic ileum and colon lesions, respectively. Microscopic examination of BD patients with normal colon and terminal ileum at colonoscopy revealed 61% abnormal ileum histologies. That ratio was 30% for the control group (p < 0.001). None of the patients had any lesions suggesting BD at upper GI endoscopy. There was no correlation between macro- or microscopic GI involvement and other components of BD. Conclusions: Lower GI tract, especially ileum involvement, is frequent in BD. Most of the patients have inflammation in the ileum even in the absence of macroscopic lesions.

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“…7,8 Patients with intestinal Behcet's disease were considered to have achieved remission or to have relapsed as described previously. 9 Blood samples for TPMT/ITPA genotyping were collected from patients at the initial clinic visit. Genomic DNA was extracted from blood after informed consent was obtained.…”

Section: Methodsmentioning

confidence: 99%

Correlation of genotypes for thiopurine methyltransferase and inosine triphosphate pyrophosphatase with long-term clinical outcomes in Korean patients with inflammatory bowel diseases during treatment with thiopurine drugs

et al. 2009

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There is a lack of research describing the associations between thiopurine methyltransferase (TPMT)/inosine triphosphate pyrophosphatase (ITPA) genotypes and long-term clinical outcomes. We investigated whether TPMT/ITPA genotypes predicted long-term clinical response in Korean patients with inflammatory bowel diseases (IBDs) undergoing thiopurine treatment. A total of 204 patients with IBD in whom thiopurine treatment was indicated were enrolled and categorized by TPMT and ITPA genotypes. Long-term follow-up clinical data for these patients were analyzed with specific focus on disease relapse. Of the 204 patients, 162 (79.4%) patients using thiopurines achieved remission and were included in an analysis of long-term clinical outcomes. There were no significant differences in disease relapse-free survival between wild and mutant types of TPMT (P¼0.903) or ITPA (P¼0.392), according to the results of the log-rank analysis. Our study suggests that TPMT and ITPA genotypes may not affect the rates of disease relapse in IBD patients treated with thiopurines. Further studies are indicated to confirm the utility of TPMT/ITPA genotyping to guide clinicians formulating individualized treatments for IBD patients requiring thiopurine therapy. Keywords: azathioprine; inflammatory bowel disease; inosine triphosphate pyrophosphatase; relapse; thiopurine S-methyl transferase INTRODUCTION Thiopurine drugs, 6-Mercaptopurine (6-MP) and its prodrug azathioprine (AZA), are effective for the induction and maintenance of remission in patients with inflammatory bowel disease (IBD). 1,2 There has been tremendous interest with regard to thiopurine metabolism as a means of identifying ways in which individual therapy might maximize clinical response and minimize adverse effects. Genetic polymorphisms in the thiopurine S-methyl transferase (TPMT) gene have been associated with decreased TPMT activity and the development of myelotoxicity due to high thioguanine metabolite concentrations. 3,4 Moreover, inosine triphosphate pyrophosphatase (ITPA) deficiency has recently been associated with AZA toxicity because of the accumulation of 6-thioinosine-triphosphate. 5,6 Theoretically, low TPMT activity might also augment the therapeutic efficacy of thiopurines and lead to better long-term clinical outcomes. To confirm the usefulness of the TPMT/ITPA genotype or TPMT activity in clinical prediction, research regarding the relevance of measurement for prevention of both adverse effects and clinical outcomes is necessary. However, the impact of the TPMT/ITPA genotype on long-term clinical response of IBD patients treated with AZA/6-MP has not yet been examined. In this study, we investigated whether TPMT/ ITPA genotypes could affect long-term clinical outcomes as measured by disease relapse in Korean patients with IBD undergoing AZA or 6-MP treatment. MATERIALS AND METHODSA total of 204 patients with IBD (105 patients with Crohn's disease, 59 with ulcerative colitis and 40 with intestinal Behcet's disease) were initiated on AZA treatment during the s...

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Prediction of the Clinical Course of Behçet's Colitis According to Macroscopic Classification by Colonoscopy

Abstract: Volcano-type ulcerations in Behçet's colitis showed a less favorable response to medical treatment, a more frequent requirement for surgery, and more frequent recurrences than the geographic and aphthous types of ulcerations.

Cited by 59 publications

References 12 publications

Prognostic factors and long-term clinical outcomes for surgical patients with intestinal Behcetʼs disease

Prognostic factors and long-term clinical outcomes for surgical patients with intestinal Behcetʼs disease

Ileocolonic Involvement in Behçet’s Disease: Endoscopic and Histological Evaluation

Correlation of genotypes for thiopurine methyltransferase and inosine triphosphate pyrophosphatase with long-term clinical outcomes in Korean patients with inflammatory bowel diseases during treatment with thiopurine drugs

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