摘要
Abstract
Objective To explore the clinical features,diagnosis and differential diagnosis of intestinal Behcet's dis-ease,and to summarize and analyze the causes of misdiagnosis and preventive measures.Methods From January 2014 to May 2024,the clinical data of 7 patients with intestinal Behcet's disease,which were initially misdiagnosed as inflammatory bowel disease and appendicitis,were retrospectively analyzed.Results The main clinical manifestations of 7 patients were abdominal pain,diarrhea,gastrointestinal bleeding,fever,abdominal tenderness and rebound pain.Blood routine examina-tion of 4 patients showed increased leukocytes and neutrophils.Erythrocyte sedimentation rate increased in 6 patients,and C reactive protein increased in 5 patients.All patients were negative for anti-neutrophil cytoplasmic antibody,anti-nuclear an-tibody,anti-double-stranded DNA antibody and anti-ENA antibody.IgG increased in 4 patients,while complement C3 and C4 decreased in 5 patients.Perinuclear anti-neutrophil cytoplasmic antibody was positive in 2 patients,anti-cardiolipin antibody was positive in 1 patient,rheumatoid factor was positive in 1 patient,and stool occult blood test was positive in 4 patients.Gastroscopy showed reflux esophagitis in 1 patient.Colonoscopy showed the formation of multiple ulcers in the colon and rec-tum,accompanied by different degrees of mucosal congestion,erosion,intestinal stenosis and deformation,and multiple pol-yps in the colon.Acute and/or chronic inflammation of ileocecal/colonic mucosa was found in 7 patients as pathological mani-festations by intestinal mucosal biopsy.In primary hospitals,4 patients were misdiagnosed with inflammatory bowel disease and 3 patients with appendicitis.After admission to our hospital,the patients were diagnosed with intestinal Behcet's disease according to clinical manifestations,laboratory examination,gastroenteroscopy and related diagnosis and treatment guidelines,and the misdiagnosis lasted 23 d to 12 years.After diagnosis,7 patients were treated with glucocorticoids and(or)combined immunosuppressive agents;patients with gastric ulcer and reflux esophagitis were treated with acid suppressive agents and mu-cosal protective agents;patients with intestinal perforation or massive hemorrhage were treated with surgery.All 7 patients were discharged with improved condition.Conclusion Bowel Behcet's disease is prone to misdiagnosis.Clinicians should en-hance the vigilance of the disease,perform timely colonoscopy and pathological examination on those patients,and conduct comprehensive analysis according to the clinical manifestations and other medical examination results,for the purpose of early diagnosis and treatment.关键词
白塞病,肠型/误诊/炎症性肠病/阑尾炎/鉴别诊断Key words
Behcet's disease,bowel type/Misdiagnosis/Inflammatory bowel disease/Appendicitis/Differential di-agnosis分类
临床医学
