Behçet's disease departs the 'Silk Road': a case report and brief review of literature with geographical comparison

Journal of Community Hospital Internal Medicine Perspectives
Zohair AhmedSonu Dhillon

Abstract

Behçet's disease (BD) is a chronic multisystem inflammatory disease most prevalent in Eastern Asia and along the Mediterranean basin, an area referred to as the 'Silk Road'. The diagnosis of BD is largely based on the International Study Group (ISG) criteria, which are more specific than sensitive. ISG criteria do not include intestinal manifestations, a feature more commonly seen in the West. Intestinal BD is one of several findings that are not typically seen along the 'Silk Road'. Herein we report a rare case of intestinal BD and compare Western versus traditional BD. A 25-year-old male with a history of painful oral aphthous ulcers, pericarditis, and diffuse papulopustular rash presented to the emergency department with two terminal ileal perforations. Pathology demonstrated mucosal necrosis with active inflammation and no chronic inflammatory changes. Post-surgical laboratory studies showed an elevated c-reactive protein of 35.57 mg/dL, erythrocyte sedimentation rate of 82 mm/h, and a positive anti-Saccharomyces cerevisiae antibody. Rheumatological workup including ANA, RF, PR3 antibody, MPO antibody, ANCA, SSA and SSB, Smith antibody, SCL-70, and anti-Jo-1 antibodies were all negative. His pericarditis symptoms improved w...Continue Reading

References

Jul 1, 1993·Radiology·M IidaM Fujishima
Aug 29, 1997·International Journal of Cardiology·O GöldeliB Cetinarslan
Mar 24, 1998·Yonsei Medical Journal·A GürlerU Türsen
Oct 3, 2003·International Journal of Dermatology·Gülsevim AzizlerliRian Dişçi
Mar 6, 2007·Nature Clinical Practice. Rheumatology·Hasan YaziciSebahattin Yurdakul
Jun 16, 2012·Der Ophthalmologe : Zeitschrift der Deutschen Ophthalmologischen Gesellschaft·A AltenburgC C Zouboulis

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Methods Mentioned

BETA
electrophoresis
ESR
biopsy

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