ENTERO-BEHCET AND CROHN’S DISEASE – A CONUNDRUM
Sudhir K. Atri, Nitin Kumar , Piyush Malik
Department Of Internal Medicine , Pt .B. D Sharma PGIMS Rohtak
INTRODUCTION
Behcet’s disease is a chronic
relapsing, multisystemic, inflam-
matory disorder Usually presenting
as triad of repeated oral ulcers,
genital ulcers and bilateral uveitis, it
may involve other system including
gastro-intestinal system GI
manifestations such as abdominal
pain, diarrhea, nausea are quite
common in patients with Behcet’s but
Intestinal ulcer-ations known as
intestinal Behcet’s disease is
relatively rare.
CASE REPORT
A 47year male presented with
persistant loose stool with pain
abdomen associated with Recurrent,
painful, aphthous oral and genital
ulcers since 6 months. patient had
CRP was raised >156 with microcytic
anaemia hb -7.1 with hypoprotien-
emia total protein-5.6. Iron Profile
done revealed anaemia of chronic
disease. S. B12 and S. Vit D3 were
also decreased suggestive of
chronic malabsorption. Colonoscopy
was done revealed focal solitary deep DISCUSSION
round ulcers in caecum and colon. HLA
Intestinal BD and CD are inflammatory
B51 was done came out Positive.
disease with similar extra-intestinal
Patient met the ISG criteria of behcet’s
clinical features. There are no patho-
disease with total score of 5 .Patient
gnomonic laboratory test or endo-
was started on corticosteroid and
scopic findings of BD which can
colchicine, and patient responded well
differentiate it from crohn’s although
and symptomatically improved with
few, large, deep ulcers with discrete
resolution of oral and genital ulcers.
borders are described as character-
istic pattern in intestinal BD. Treat-
ment for intestinal BD is similar to CD,
such as steroids, immunomodulators
and biologic agents.
CONCLUSION
Behçet’s disease can present with a
wide array of gastrointestinal mani-
festations. Intestinal BD and Crohn’s
disease differentiation remains a
challenge for physician as both
conditions have significant clinical and
On colonoscopy, Multiple superficial ulceration
present in caecum and transverse colon with one
diagnostic overlap. The goal of treat-
deep ulcer present on ileocolic junction . Ascen-ding ment is to keep patients in clinical
and descending colon, anal mucosa was normal. remission, reduce relapses and
prevent surgical intervention.