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Diagnosis of Behcet Disease, Especially Intestinal Behcet T. Ogino 1 , T. Shimizu 1 1The Second Department of Internal Medicine, Teikyo University School of Medicine pp.893-901
Published Date 1979/7/25
DOI https://doi.org/10.11477/mf.1403107714
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 The Behcet's Disease Research Committee of Japan, established by the Ministry of Health and Welfare in 1972, developed a set of diagnostic criteria. The criteria are set forth in table 1; they serve better for purposes of classification than as discriminators, however. Because of the frequency of their conjunction, recurrent oral aphthous ulcers, skin eruptions (especially those resembling erythema nodosum, folliculitis, and subcutaneous thrombophlebitis), ocular involvement (especially uveitis), and genital ulceration are considered the four major symptoms of the disease.

 Articular, gastrointestinal, vascular, and nervous system involvement were classified as minor criteria, not because lesser severity or better prognosis was claimed, but because frequency of occurrence was significantly less. Epididymitis and other organ symptoms have recently been added to this classification as well.

 It was proposed by this Committee that if all four major symptoms appeared during the clinical course of the patient's disease, the syndrome would be labeled “complete” while if only three of the four major symptoms appeared, it would be called incomplete. If a particularly characteristic finding, such as recurrent hypopyon iritis or typical chorioretinitis appeared, then only one other major symptom needed to develop for a diagnosis of “incomplete type” to be tenable. Any number of minor criteria could accompany any of the major criteria, however. The complete type is not necessarily more severe than the incomplete type. In all instances, ocular involvement tends to present the most serious problems for the patient. Blindness remains a potent threat. However, deaths resulting from Bechet's syndrome (a mortality rate of 3 to 4%) usually result from rupture of aneurysms, perforation of the intestines, or severe central nervous system involvement.

 11 cases of Behcet syndrome with intestinal involvement treated by bowel resection were shown with past history and present illness. Clinical courses were noted in Table 4. These cases were divided into two pattern; (Ⅰ) Behcet syndrome preceding, (Ⅱ) Ietestinal ulcers preceding.

 In the former pattern, (Ⅰ), major symptoms of Behcet syndrome appear before bowel resection, and in the latter pattern, (Ⅱ), major symptoms appear after bowel resection.


Copyright © 1979, Igaku-Shoin Ltd. All rights reserved.

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電子版ISSN 1882-1219 印刷版ISSN 0536-2180 医学書院

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