Clinical Analysis Of 36 Cases Of Intestinal Behcet’s Disease

Clinical analysis of 36 cases of intestinal behcet’s disease[Objective]The paper is to study patients who are suffering from intestinal Behcet’s disease. In order to acquaint more about the disease, and increase the possibility of recovery, many studies were done, such as clinical manifestations, laboratory tests, imaging characteristics, endoscopic presentation, pathologic features, diagnosis and treatment of the patients.[Materials and methods]According to the International study group of Behcet’s Disease, diagnostic criteria and classification solutions were made. Reviewing the retrospective analysis of Shanghai Huadong Hospital from October in 2012 to January in 2014,36 cases of clinical data of intestinal Behcet’s disease were statistically analyzed with the application of SPSS 18.0.[Results]①Generally, the patients were 18-65 years old with average age of 30.1. The duration of the patients was from 7 months to 30 years, with the average of 8.15 years. The male/female ratio was 1.18:1.②Clinical manifestations showed that 91.7%(33/36) of the patients had the digestive tract symptoms later than the appearance of BD system disease. The symptoms of the disease were abdominal pain, bloating, diarrhea, and other gastrointestinal manifestation,among which Abdominal pain took the majority. Gastrointestinal bleeding, intestinal perforation, intestinal obstruction, intestinal fistula formation were also the common complication of Behcet’s disease.③Laboratory tests:The main manifestations of the disease were the percentage of CD8+T cell and CD4+T cell increasing, abnormal count of WBC, abnormity of the Neutrophil and Hemoglobin, and faster Erythrocyte sedimentation rate, increased of I collagen carboxy and the C-reactive protein, and decreased of Natural killer. Sixty percentage of the patients were with acupuncture of positive reaction, and the rate of positive reaction was 36.7%. After researching on relationship of the abnormal indicators and the BD gastrointestinal lesions, we found that there was obvious difference between the influence caused by the Neutrophil and the hemoglobin.The average percentage of neutrophil cell in the upper gastrointestinal ulcer group was lower than that in none ulcer group,while in the lower gastrointestinal ulcer group was on the contrary.The hemoglobin in the upper gastrointestinal ulcer patients was higer than none ulcer group,while in the lower gastrointestinal was opposite.④From the imaging inspection, the main performance was thickening and appreciation of the ileocecal valve lesions, which accounts 55.6%(5/9).⑤Symptoms of the ileocecal involvement were mostly probable in endoscopy inspection, with ratio of 36.1%(13/36), followed by stomach and esophagus of percentage of 30.6% (11/36)and 16.7%(6/36) respectively. Endoscopic ulcer is mainly manifested as aphthous ulcers and irregular shallow ulcers, followed by isolated deep ulcers.⑥Pathology:The biopsy specimens of the endoscopic were all without vasculitis. Eight of the 26 cases in the endoscopic biopsy specimens were with non-specific acute and chronic gastrointestinal mucosal inflammation; Twelve of the 17 cases in endoscopic biopsy specimens were with non-specific acute and chronic gastrointestinal mucosal inflammation. There were six cases formed of inflammatory granulation tissue.⑦Diagnosis:The ratio of misdiagnosis for the first time is high, which are commonly diagnosed as inflammatory bowel disease (3 cases) and appendicitis (1 case).⑧ Treatment and prognosis:The treatments of the disease were mainly glucocorticoid drugs and Sulfasalazine therapy. However, when the patients adjusted other drugs or reduced the quantity, the disease would relapse. The drug therapy of the intestinal ulcers was poorer and easier to relapse than the esophagus, stomach, duodenum. Patients could be treated with combined immunosuppressive or tumour necrosis factor antagonists therapy if relapsed.⑨ After comparing between the general situation, clinical manifestations, laboratory findings, and endoscopic findings of patients who injected of complete and incomplete Behcet’s disease, there were no statistically significant difference in all of the data except for the albumin and Immunelglobins E. The two indicators in complete intestinal behcte’s disease were significant higer than incomplete type.[Conclusions]1. Intestinal Behcet’s disease is more common in young adults, and the cycle is long. Misdiagnosis rate is high for the first time.2. The gastrointestinal symptoms are always after the BD symptoms. Abdominal pain is the most common symptom. The common symptoms of the intestinal Behcet’s disease are gastrointestinal bleeding, intestinal perforation, fistula formation, intestinal obstruction. There was no significant difference between the complete and incomplete intestinal Behcet’s disease except for the albumin and Immunelglobins E.The two indicators in complete intestinal behcte’s disease are significant higer than incomplete type.3. There is obvious difference between the influence caused by the Neutrophil and the Hemoglobin from the laboratory research. The average percentage of neutrophil cell in the upper gastrointestinal ulcer group is lower than that in none ulcer group,while in the lower gastrointestinal ulcer group is on the contrary.The hemoglobin in the upper gastrointestinal ulcer patients is higer than none ulcer group,while in the lower gastrointestinal is opposite.4. Lesions appear in ileocecum commonly, followed by the stomach and esophagus. The symptoms are ulcers seen from the endoscopic.5. The treatment with corticosteroids and Sulfasalazine therapy, combined with tumor necrosis factor antagonists or immunosuppressive were significantly effective.