Analysis of clinical course and long-term prognosis of surgical and nonsurgical patients with intestinal Behcet's Disease

OBJECTIVE: Much remains unknown about the pathogenesis of intestinal Behcet 's disease. The majority of these patients are treated with surgical interv ention, although it has been recently reported that a number of medical tre atments are sometimes effective. Only few studies, however, have ever been undertaken to analyze the long-term prognosis of this disease. In this stud y, we analyzed the clinical course and the recurrences after initial therap y in patients with intestinal Behcet's disease. METHODS: We investigated 20 patients (surgical group, n = 8; nonsurgical gr oup, n = 12) for whom the clinical courses were known for greater than or e qual to 2 yr (2-23 yr). RESULTS: The surgical group tended to have higher rates of complications su ch as ocular and ileal lesions than the nonsurgical group. In the surgical group, 75% of the patients recurred (and were readmitted) within 2 yr, and 37.5% of the patients required reoperation for intestinal obstruction becau se of ulcer at the anastomosis. The percentage of peripheral CD8+DR+ lympho cytes in the recurrent group (10.4% +/- 2.5%) was significantly higher than that in the nonrecurrent group (4.3% +/- 1.2%, p < 0.05). CONCLUSIONS: Our results indicate that more extensive disease involving the ileum and ocular lesions are markers of severity and progression to surgic al crisis, and that patients requiring surgery suffer more frequent recurre nces. Furthermore, an increased percentage of peripheral CD8+DR+ lymphocyte s may be a risk factor for disease recurrence. (Am J Gastroenterol 2000;95: 2848-2851. (C) 2000 by Am. Coll. of Gastroenterology).