Clinical, Endoscopic, and Histopathologic Gastrointestinal Disease in an American Cohort with Behçet's Disease

Introduction:Behçet's disease (BD) is a chronic systemic vasculitis characterized by oral and genital ulcers, uveitis, and skin lesions. Patients with BD may develop gastrointestinal disease however characterization of gastrointestinal disease in American cohorts is lacking. Here we present clinical, endoscopic, and histopathologic GI findings in an American cohort of BD patients.Methods:Patients with established BD were evaluated prospectively at the National Institutes of Health. Demographic and clinical data were collected including Behçet's disease manifestations and gastrointestinal symptoms. Endoscopy with histopathologic sampling was performed for both clinical and research indications with written consent.Results:Eighty-three patients were evaluated. The majority were female (83.1%) and White (75.9%). Mean age was 36 ± 14.8 years. Gastrointestinal symptoms were reported in 75% of cohort with nearly half of reporting abdominal pain (48.2%) and significant numbers reporting acid reflux, diarrhea, and nausea/vomiting. Esophagogastroduodenoscopy (EGD) was performed in 37 patients; erythema and ulcers were the most common found abnormalities. Colonoscopy was performed in 32 patients with abnormalities including polyps, erythema, and ulcers. Endoscopy was normal in 27% of EGDs and 47% of colonoscopies. Vascular congestion was demonstrated on the majority of random biopsies throughout the gastrointestinal tract. Inflammation was not highly prevalent on random biopsies except in the stomach. Wireless capsule endoscopy was performed on 18 patients; ulcers and strictures were the most common abnormalities.Conclusions:Gastrointestinal symptoms were common in this cohort of American patients with BD. Endoscopic examination was often normal however histopathologic examination demonstrated vascular congestion throughout the gastrointestinal tract.