INTESTINAL BEHCETS-DISEASE - PATHOGNOMONIC CHANGES IN INTRAMUCOSAL LYMPHOID-TISSUES AND EFFECT OF A REST CURE ON INTESTINAL LESIONS

To clarify the pathognomonic changes of intestinal lesions of Behcet's disease and to determine effective therapeutic measures, we recruited 13 patients with the intestinal form of this disease for study. We pe rformed pathology studies on the resected specimens of 7 patients and treated 5 of the other 6 patients with a low-residue diet. Pathology e xamination revealed that 6 of the 7 had inflammatory ulcerations in th e ileocecal region. The ileal ulcers were mainly on the antimesenteric side. We observed remnants of Peyer's patches at the margins of the m ajor ulcerative lesions in 2 of 2 patients examined. There were aggreg ations of lymphocytes resembling destroyed lymph follicles in the supe rficial layer at the mouths of small fissuring lesions, and ulcer scar s were also noted in Peyer's patches in 4 of 5 other patients. X-ray a nd endoscopic examinations revealed the disappearance of intestinal le sions in 5 patients within 1 month during, or following the low-residu e diet treatment. We found the intestinal lesions of Behcet's disease at sites coinciding with intramucosal lymphoid tissue. The ''rest cure '' for the affected bowel was effective, i.e., there was significant a lleviation of gastrointestinal symptoms and the intestinal lesions dis appeared. We speculated that acute exudative inflammation, abscess for mation, and consequent ulceration may occur in these tissues by the sa me mechanisms as those that operate in the positive needle-prick react ions seen in patients with Behcet's disease.