CLINICAL COURSE and RELAPSE RATE IN INTESTINAL BEHCET'S DISEASE

Behcet's disease is a multisystemic recurrent inflammatory disease. Gastrointestinal tract involvement in Behcet's disease has been identified throughout the alimentary tract and causes diverse symptoms. Various treatment have been utilized to induce or maintain remission. However, little is known about clinical course and prognosis in Behcet's disease with intestinal involvement. The aims of this study were to evaluate the clinical course and relapse rate in intestinal Behcet's disease and to investigate factors that may affect relapse. Methods Clinical course and characteristics, including demographic parameters, gastrointestinal symptoms as well as systemic manifestations, laboratory data, endoscopic findings, and treatment strategies for the induction of remission, of 97 patients (49 male, 48 female) with intestinal Behcet's disease were retrospectively reviewed. Cumulative relapse free rate and factors related with relapse were analysed by Kaplan–Meier method and log–rank test, respectively. Results The median duration of the relapse free period was 7 months (ranges from 1 to 171 months). One, two, and five year relapse free rates were 41.2, 29.7 and 10.2%, respectively. Sex, clinical subtype of Behcet's disease, symptom and laboratory data at onset, colonoscopic findings, such as distribution of lesions as well as number, size, depth, and shape of ulcer, and initial treatment (medical vs. surgical) did not affect relapse rate. However, large ulcers (> 20 mm) and young age at onset (< 37 years old) were factors significantly related with higher relapse rate (P < 0.05, log–rank test). Conclusion High relapse rate in intestinal Behcet's disease was identified. Age at onset and size of the ulcer are factors related with long-term prognosis of intestinal Behcet's disease.