No abstract available.
Behcet Syndrome/*pathology ; Female ; Humans ; Interleukins/*blood ; Male ; Receptors, Cell Surface/*blood

Behcet's disease (BD) is a multisystem vascular inflammatory disease. BD can affect blood vessels of nearly all sizes and types. Arterial involvement is a rare but serious condition in the course of BD. Here, we report a case of stenosis at the iliac artery bifurcation which was treated with percutaneous balloon angioplasty and stent implantation in a 37-year-old patient with BD.
Adult ; Angioplasty, Balloon ; Behcet Syndrome ; Blood Vessels ; Constriction, Pathologic* ; Humans ; Iliac Artery ; Stents*

Adult ; Behcet Syndrome ; complications ; diagnosis ; Blood Sedimentation ; C-Reactive Protein ; analysis ; Cardiovascular Diseases ; etiology ; Humans ; Male

Antiendothelial cell antibodies (AECA) have been detected in the sera of patients of autoimmune diseases showing vasculitis. Using IgM-ELISA, we found AECA in 42 (56%) of 75 sera samples from patients with Behcet's disease in a previous study. All of the 15 AECA-positive sera of Behcet's disease patients had an increased expression of the intercellular cell adhesion molecule-1 (ICAM-1), 93.3% of the sera induced the vascular cell adhesion molecule-1 (VCAM-1), and 100% of the serum induced the E-selectin molecule on human dermal microvascular endothelial cells (HDMEC). After stimulation of HDMEC with AECA-positive sera of Behcet's disease patients, the expression of ICAM-1 and VCAM-1 on HDMEC increased significantly at 4 hours, reaching a peak at 16 hours. Expression of E-selectin was induced at 1 hour after stimulation with a peak at 4 hours and it decreased thereafter. Adherence of T lymphocytes to HDMEC increased significantly after stimulation with AECA-positive sera from Behcet's disease patients. Also, the adherence of T lymphocytes to HDMEC increased at 4 hours and returned to its normal level at 48 hours. These results show that AECA-positive sera of Behcet's disease patients are capable of activating HDMEC to promote the adherence of T lymphocytes to increase the expression of ICAM-1, VCAM-1, and E-selectin on the cell surfaces. The whole process may play an important role in the pathogenesis of vasculitis in Behcet's disease.
Antibodies/physiology* ; Antibodies/blood ; Behcet's Syndrome/immunology ; Behcet's Syndrome/blood* ; Blood Physiology ; Cell Adhesion/physiology ; Cells, Cultured ; Endothelium, Vascular/physiology* ; Endothelium, Vascular/immunology* ; Endothelium, Vascular/cytology ; Human ; Microcirculation/physiology ; Skin/blood supply* ; T-Lymphocytes/physiology*

OBJECTIVES: To analyze arthritic manifestations in Behcet disease, which is one of the most common manifestations of Behcet disease. METHODS: Among the patients who visited the Rheumatology Division, Keimyung University Dongsan Medical Center, Taegu, Korea from March 1997 to February 1998, 35 patients, with more than 3 months follow-up, were compatible for the diagnosis of Behcet disease according to the Shimizu criteria, after exclusion of uncertain or possible Behcet cases. The presence of various manifestations was evaluated. Regarding the joint manifestations, the involved joint, signs and the pattern of the articular symptoms were examined. Basic laboratory tests, HLA studies and simple radiologic studies were done. RESULTS: All 35 patients had evident, recurrent, painful oral ulcers by the study definition. Genital ulcers were found in 29%, skin lesions in 77%, uveitis in 9%, gastrointestinal ulcerations in 6% and vascular manifestations in 6%. Joint manifestations appeared in 97%. Knee(91%), proximal interphalangeal (53%) and metacarpophalangeal joints(21%) were the main sites. Tenderness was prominent in 91% and swelling in 44%. Polyarticular presentation was found in 47%. In most cases (76.4%), the articular symptom was short-lasting. C-reactive protein was likely to be positive in active Behcet disease. HLA B51 was positive in 46%. CONCLUSIONS: In Behcet disease, various manifestations can be found. The arthritic manifestation seems quite common. It may present as seronegative rheumatoid arthritis. Otherwise, it may present as palindromic rheumatism.
Adult ; Arthritis, Rheumatoid/diagnosis* ; Arthritis, Rheumatoid/blood ; Behcet's Syndrome/diagnosis* ; Behcet's Syndrome/blood ; C-Reactive Protein/metabolism ; Comparative Study ; Diagnosis, Differential ; Female ; Human ; Joints/pathology ; Male ; Middle Age ; Rheumatic Diseases/diagnosis* ; Rheumatic Diseases/blood

PURPOSE: The serum levels of soluble triggering receptor expressed on myeloid cells-1 (sTREM-1) have recently been shown to be correlated highly with disease activity in patients with intestinal Behcet's disease (BD). However, it remains unclear whether sTREM-1 levels reflect endoscopic activity in intestinal BD. This study aimed to evaluate the correlation of sTREM-1 levels with endoscopic activity in intestinal BD. MATERIALS AND METHODS: A total of 84 patients with intestinal BD were enrolled. Endoscopic activity was compared with sTREM-1 levels as well as other laboratory findings, including erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP). RESULTS: sTREM-1 levels were significantly increased in intestinal BD patients compared with controls (37.98+/-27.09 pg/mL vs. 16.65+/-7.76 pg/mL, p=0.002), however, there was no difference between endoscopically quiescent and active diseases (43.53+/-24.95 pg/mL vs. 42.22+/-32.68 pg/mL, p=0.819). Moreover, serum sTREM-1 levels did not differ in terms of number, shape, depth, size, margin, or type of ulcer in patients with intestinal BD. However, mean ESR and CRP levels in patients with active disease were significantly higher than those in patients with quiescent disease (p=0.001, p<0.001, respectively). In addition, endoscopic activity scores for intestinal BD were correlated significantly with both CRP levels (gamma=0.329) and ESR (gamma=0.298), but not with sTREM-1 levels (gamma=0.166). CONCLUSION: Unlike CRP levels and ESR, serum sTREM-1 levels were not correlated with endoscopic activity in patients with intestinal BD.
Adult ; Behcet Syndrome/*blood/*pathology ; Biological Markers/blood ; Blood Sedimentation ; C-Reactive Protein/metabolism ; Female ; Humans ; Intestinal Diseases/*blood/*pathology ; Male ; Membrane Glycoproteins/*blood ; Receptors, Immunologic/*blood

Behcet's disease (BD) is a chronic inflammatory disorder of unknown aetiology, and recognised as a multi-system vasculitis. It has been postulated that an imbalance of the oxidant and antioxidant systems related to the disease are important in its pathogenesis. Previous publications have reported increased levels of enzymatic antioxidant defence systems in patients with BD. The non-enzymatic antioxidant systems, including vitamin C and uric acid, were looked for in the present study. For this aim, the serum malondialdehyde (MDA), an end product of lipid peroxidation, and vitamin C and uric acid, as endogenous antioxidants, were determined in 20 patients with BD (11 in active and 9 in inactive periods) and 20 healthy subjects. The MDA level was significantly higher in both the active and inactive period patients compared with the control group (p < 0.001, p < 0.05, respectively). The MDA level was also significantly higher in the active period patients compared with the inactive period patients (p < 0.05). The vitamin C levels were significantly lower in both the active and inactive period patients compared with the control group (p < 0.001, p < 0.05, respectively). There was no significant difference in the vitamin C level between the active and inactive period patients (p > 0.05). There was also no significant difference in uric acid levels between the groups (p > 0.05). In the patients group, a negative correlation was found between the levels of serum MDA and vitamin C (r=-0.517; p < 0.05). Our results indicate that decreased vitamin C and increased MDA levels reflect the increased levels of oxidative stress in BD patients, and this situation may be important in relation with its pathogenesis.
Adenosine Deaminase/metabolism ; Adult ; Ascorbic Acid/*blood ; Behcet Syndrome/*blood ; Blood Sedimentation ; Female ; Human ; Lipoproteins, LDL/blood ; Male ; Malondialdehyde/blood ; Middle Aged

Due to similar manifestations of intestinal Beh?et's disease (BD) to those of other colitis such as Crohn's disease or intestinal tuberculosis, it is still challenging for gastroenterologist to accurately diagnose intestinal BD in patients with ileo-colonic ulcers. Moreover, no reliable diagnostic criteria for intestinal BD have been developed yet. Therefore, IBD Study Group of KASID was formulated to establish the guideline for the diagnosis of intestinal BD using a modified Delphi process. The novel diagnostic criteria for intestinal BD were developed based on two aspects; colonoscopic findings and extra-intestinal systemic manifestations, in which patients were categorized into 4 groups including definite, probable, suspected, and non-diagnostic for intestinal BD. Furthermore, Disease Activity Index for intestinal BD was developed through a Korean multicenter study. These diagnostic and disease activity guidelines will contribute to understand intestinal BD.
Behcet Syndrome/classification/*diagnosis ; Blood Chemical Analysis ; Colonic Diseases/*diagnosis ; Colonoscopy ; Diagnostic Imaging ; Hematologic Tests ; Humans ; Severity of Illness Index

Behcet's disease is characterized by recurrent orogenital ulcers and ocular and cutaneous inflammatory lesions. It is a multisystem disorder affecting the skin, mucous membrane, eyes, joints, CNS and blood vessels. The vascular involvements consist of thrombophlebitis, arterial occlusion and arterial aneurysm. Rupture of large artery aneurysm is the leading cause of death in patients with Behcet's disease and surgical treatment is necessary. But, surgical treatment is often difficult and may lead to formation of further false aneurysms at the site of vascular anastomosis. Endovascular stent-graft placement emerged as an alternative treatment that is less invasive with a lower risk. We report a case of the aneurysm of right common iliac artery associated with Behcet's disease. Percutaneous stent-graft placement was attempted and successfully controlled aneurysmal manifestations.
Aneurysm* ; Aneurysm, False ; Arteries ; Behcet Syndrome* ; Blood Vessels ; Cause of Death ; Humans ; Iliac Artery* ; Joints ; Mucous Membrane ; Rupture ; Skin ; Thrombophlebitis ; Ulcer

No abstract available.
Adult ; Behcet Syndrome/complications/*diagnosis ; Colon/blood supply/pathology/surgery ; Colonoscopy ; Gastrointestinal Hemorrhage/*diagnosis/etiology/surgery ; Humans ; Ileum/blood supply/surgery ; Male ; Rectum/blood supply/surgery