Kobashigawa Tsuyoshi, Okamoto Hiroshi, Kato Junko, Shindo Hironari, Imamura Tetsuo, Iizuka Bun-ei, Tanaka Masanori, Uesato Masashi, Ohta Shu-ji, Terai Chihiro, Hara Masako, Kamatani Naoyuki
Institute of Rheumatology, Tokyo Women's Medical University, Tokyo.
Intern Med. 2004 Mar;43(3):243-7. doi: 10.2169/internalmedicine.43.243.
A 34-year-old man who had a history of ulcerative colitis (UC) was admitted to our hospital with complaints of arthralgia, erythema nodosum, recurrent oral aphthous ulcers and bloody stools. A colonoscopy revealed multiple aphthous ulcers on his cecum and colon and also revealed a transmural ulcer on his rectum consistent with a diagnosis of UC. The patient was HLA-B51 positive. Based on clinical evidence [recurrent oral ulcers, skin lesions (erythema nodosum), positivity for pathergy test] this patient was diagnosed as having Behçet's disease with gastrointestinal involvement. We describe this rare case of Behçet's disease with colitis and discuss the difficulties in making a differential diagnosis between Behçet's disease and the inflammatory bowel diseases.
一名有溃疡性结肠炎(UC)病史的34岁男性因关节痛、结节性红斑、复发性口腔溃疡和便血入院。结肠镜检查发现其盲肠和结肠有多处阿弗他溃疡,直肠有透壁性溃疡,符合UC诊断。该患者HLA - B51阳性。基于临床证据[复发性口腔溃疡、皮肤病变(结节性红斑)、针刺反应阳性],该患者被诊断为白塞病伴胃肠道受累。我们描述了这例罕见的白塞病合并结肠炎病例,并讨论了白塞病与炎症性肠病鉴别诊断的难点。