Houman H, Ben Dahmen F, Ben Ghorbel I, Chouaib S, Lamloum M, Kchir N, Ben Ammar A, Miled M
Service de Médecine Interne, Tunis, Tunisie, France.
Ann Med Interne (Paris). 2001 Nov;152(7):480-2.
The association of Behçet's disease and of Crohn's disease is exceptional, and raises a nosological problem.
A 24 year-old female developed since 1996 chronic diarrhea, abdominal pain, recurrent oral and genital ulcer and polyarthralgia. Endoscopic colonoscopy examination showed a diffuse colitis. Histological examination revealed epitheloid granuloma without vasculitis compatible with a Crohn's disease. The patient was treated with oral prednisone (1mg/kg/day). In November 1998, she was admitted for diarrhea. Many pseudofolliculitis lesions, uveitis and positive pathergy test were noted. The HLA was B 51. The diagnosis of Crohn's disease associated with Behçet's disease was made. She was treated with high doses of prednisone (1mg/kg/day and 6 monthly intravenous pulses of cyclophosphamide). Skin lesions and diarrhea improved within few days, and cleared completely within five months. Presently, the patient remains clinically free of disease.
While being of different pathogenic origin, Behçet's disease and Crohn's disease may coexist within one and the same patient and cause diagnostic and therapeutic problems.
白塞病与克罗恩病的关联极为罕见，引发了一个疾病分类学问题。
一名24岁女性自1996年起出现慢性腹泻、腹痛、复发性口腔溃疡和生殖器溃疡以及多关节痛。内镜结肠镜检查显示弥漫性结肠炎。组织学检查发现上皮样肉芽肿，无血管炎，符合克罗恩病表现。患者接受口服泼尼松（1毫克/千克/天）治疗。1998年11月，她因腹泻入院。发现多处假性毛囊炎病变、葡萄膜炎和针刺反应阳性。人类白细胞抗原为B51。诊断为克罗恩病合并白塞病。她接受了高剂量泼尼松（1毫克/千克/天）及每6个月1次的静脉注射环磷酰胺治疗。皮肤病变和腹泻在数天内改善，并在5个月内完全消退。目前，该患者临床症状消失。
尽管白塞病和克罗恩病病因不同，但它们可能在同一患者体内共存，并引发诊断和治疗难题。
