Tolia V, Abdullah A, Thirumoorthi M C, Chang C H
Department of Pediatrics, Wayne State University School of Medicine, Detroit, Michigan.
Am J Gastroenterol. 1989 Mar;84(3):322-5.
A 15-yr-old, Arabic male presented with painful, recurrent, self-resolving oral and genital ulcers, erythema nodosum and uveitis. Behcet's disease was diagnosed. A few months later, he experienced anorexia, abdominal pain, diarrhea, and weight loss. Although all routine laboratory and radiologic investigations were negative, colonoscopy revealed the presence of serpiginous ulcers with pseudopolyps and inflamed intervening mucosa in the proximal half of the colon. Therapy with oral steroids was helpful, but the disease exacerbated a few months after prednisone was discontinued. Repeat evaluation showed similar endoscopic findings and, on colonic biopsy, noncaseating granulomas compatible with Crohn's disease were seen. Again, the patient responded well to oral steroids and sulfasalazine. We believe that gastrointestinal involvement in our patient is compatible with Crohn's disease and that screening tests to rule out chronic inflammatory bowel disease should be performed in the presence of gastrointestinal involvement in Behcet's disease. Behcet's disease may be a part of the spectrum of chronic inflammatory bowel disease.
一名15岁的阿拉伯男性患者，出现疼痛性、复发性、可自行缓解的口腔和生殖器溃疡、结节性红斑和葡萄膜炎。诊断为白塞病。几个月后，他出现厌食、腹痛、腹泻和体重减轻。尽管所有常规实验室和影像学检查均为阴性，但结肠镜检查显示结肠近端有匐行性溃疡、假息肉以及中间黏膜发炎。口服类固醇治疗有效，但停用泼尼松几个月后病情加重。再次评估显示类似的内镜检查结果，结肠活检可见与克罗恩病相符的非干酪样肉芽肿。患者再次对口服类固醇和柳氮磺胺吡啶反应良好。我们认为该患者的胃肠道受累与克罗恩病相符，在白塞病出现胃肠道受累时应进行筛查试验以排除慢性炎症性肠病。白塞病可能是慢性炎症性肠病谱的一部分。
