Hisamatsu Tadakazu, Naganuma Makoto, Matsuoka Katsuyoshi, Kanai Takanori
Division of Gastroenterology and Hepatology, Department of Internal Medicine, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582 Japan.
Center for Diagnostic and Therapeutic Endoscopy, School of Medicine, Keio University, Tokyo, Japan.
Clin J Gastroenterol. 2014 Jun;7(3):205-12. doi: 10.1007/s12328-014-0488-0. Epub 2014 Apr 20.
Behçet's disease (BD) is a chronic relapsing disease with multiple organ system involvement characterized clinically by oral and genital aphthae, cutaneous lesions, and ophthalmological, neurological, and/or gastrointestinal manifestations. Little clinical evidence is available regarding the management of patients with intestinal BD, despite recognition that the presence of intestinal lesions is a poor prognostic factor, causing perforation and massive bleeding. Many recent case reports have suggested that anti-tumor necrosis factor alpha (TNF)α monoclonal antibodies (mAbs) are effective in patients with intestinal BD. Adalimumab, a fully human anti-TNFα mAb, has been approved in Japan for the treatment of intestinal BD. Here, we review the pathogenesis, diagnosis and management of intestinal BD, including evidence of the efficacy of anti-TNFα mAbs.
白塞病(BD)是一种多系统受累的慢性复发性疾病,临床特征为口腔和生殖器溃疡、皮肤病变以及眼科、神经科和/或胃肠道表现。尽管认识到肠道病变的存在是一个不良预后因素,可导致穿孔和大出血,但关于肠道白塞病患者的管理,临床证据很少。最近许多病例报告表明,抗肿瘤坏死因子α(TNF)α单克隆抗体(mAb)对肠道白塞病患者有效。阿达木单抗是一种全人源抗TNFα单克隆抗体,已在日本获批用于治疗肠道白塞病。在此,我们综述肠道白塞病的发病机制、诊断和管理,包括抗TNFα单克隆抗体疗效的证据。