1.Diagnostic criteria of Behcet's disease: problems and suggestions.
Yonsei Medical Journal 1997;38(6):365-369
There are no specific diagnostic laboratory tests for Behcet's disease. Diagnosis relies on proper history-taking and typical clinical manifestations. To provide more objectivity to the diagnosis, several diagnostic criteria have been introduced including one major set of guidelines by the International Study Group for Behcet's Disease (ISGBD) in 1990 which has made a significant contribution, although some disagreements exist in interpretation. Based on this criteria, recurrent oral ulceration is an obligatory manifestation for the diagnosis of Behcet's disease; however, some data indicates it is not a requirement for the diagnosis. In this article the author critically reviews different accepted diagnostic criteria or classifications of Behcet's disease and gives recommendations for a more thorough diagnosis.
Behcet's Syndrome/diagnosis*
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Behcet's Syndrome/classification
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Human
2.Survey and Validation of the Criteria for Behcet's Disease Recently Used in Korea: a Suggestion for Modification of the International Study Group Criteria.
Hyun Kyu CHANG ; Seung Yong KIM
Journal of Korean Medical Science 2003;18(1):88-92
The criteria employed for Korean Behcet's disease (BD) from January 1990 to December 2000 have been investigated, and the diagnostic validity for those criteria was determined. For the generation of a modified set of preliminary criteria from the International Study Group (ISG) criteria, the diagnostic values for individual feature of BD were calculated. The criteria by the Behcet's Disease Research Committee of Japan appeared to be widely employed with the ISG criteria. However, because the ISG criteria revealed a relatively valid outcome in Korea, the application of this criteria will be needed for the universal unification until the criteria with better performance comes out. On the other hand, the modified set of preliminary criteria that consisted of the clinical items with better results seemed to improve some pitfalls of the ISG criteria. Although that criteria showed better performance than the preexisting criteria, it should be necessary to validate its effectiveness in other areas.
Behcet Syndrome/classification
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Behcet Syndrome/diagnosis*
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Behcet Syndrome/epidemiology
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Bibliometrics
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Data Collection
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Databases, Factual
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Human
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Korea/epidemiology
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Likelihood Functions
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Prevalence
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Sensitivity and Specificity
3.Recurrent aphthous stomatitis in the diagnosis of Behcet's disease.
Yonsei Medical Journal 1997;38(6):370-379
Recurrent aphthous stomatits (RAS) is also known as recurrent oral ulcers, recurrent aphthous ulcers, or simple or complex aphthosis. RAS is the most common inflammatory ulcerative condition of the oral mucosa in North American patients. RAS has been the subject of active investigation along multiple lines of research including epidemiology, immunology, clinical correlations and therapy. Clinical evaluation of the patient requires correct diagnosis of RAS and classification of the disease based on morphology (MIAU, MJAU, HU) and severity (simple versus complex). In order to properly diagnose and treat a patient with lesions of RAS, the clinician must exclude other causes of acute oral ulcers. Complex aphthosis and complex aphthosis variants associated with systemic disorders should be considered. The aphthous-like oral ulcerations of patients with HIV disease represent a challenging differential diagnosis. The association of lesions of RAS with hematinic deficiencies and gastrointestinal diseases provides an opportunity to identify a "correctable cause" which, with appropriate treatment, can result in a remission or substantial lessening of disease activity. Finally, when all of these factors are considered, the evaluation of the patient for Behcet's disease can be continued on firm grounds that one of the major criteria for the diagnosis of Behcet's disease has been met.
Behcet's Syndrome/diagnosis*
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Diagnosis, Differential
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Human
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Recurrence
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Stomatitis, Aphthous/etiology
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Stomatitis, Aphthous/diagnosis*
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Stomatitis, Aphthous/classification
4.Diagnosis of Intestinal Behcet's Disease.
Jae Hee CHEON ; Sung Jae SHIN ; Sang Woo KIM ; Kang Moon LEE ; Joo Sung KIM ; Won Ho KIM
The Korean Journal of Gastroenterology 2009;53(3):187-193
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
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Blood Chemical Analysis
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Colonic Diseases/*diagnosis
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Colonoscopy
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Diagnostic Imaging
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Hematologic Tests
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Humans
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Severity of Illness Index
5.Temporal changes in the clinical type or diagnosis of Behcet's colitis in patients with aphthoid or punched-out colonic ulcerations.
Hyun Chae JUNG ; Poong Lyul RHEE ; In Sung SONG ; Kyoo Wan CHOI ; Chung Yong KIM
Journal of Korean Medical Science 1991;6(4):313-318
The intestinal lesion of Behcet's colitis shows aphthoid or punched-out ulceration. However, the diagnosis of Behcet's colitis should be based on the presence of other stigmata of Behcet's syndrome, since these morphological characteristics are not pathognomonic by themselves. Furthermore, the stigmata of Behcet's syndrome could appear simultaneously or separately with intervals of several months to years. Besides, when a physician first meets patients with intestinal ulcerations of aphthoid or punched-out shape, if they do not have any stigma of Behcet's syndrome, the physician has some difficulty in making a diagnosis of Behcet's colitis. The purpose of this retrospective study was to investigate the followings: 1) The upgrade in clinical type of Behcet's colitis with the advance of time. 2) What portion of the patients with aphthoid or punched-out ulcerations, but without any other clinical feature of Behcet's syndrome, could be diagnosed as Behcet's colitis with the advance of time? During the mean follow-up period of 38.2 months, 4 (22.2%) out of 18 patients with Behcet's colitis upgraded their clinical types. In the nonspecific ileocolitis group, who had no major stigma of Behcet's syndrome on their initial visit, 3 (30%) out of 10 patients were subsequently diagnosed as Behcet's colitis during the mean follow-up period of 33.3 months. From these results, we could conclude that in possible or suspicious cases of Behcet's colitis, a more confident diagnosis could be made by close observations for new developments of major stigma of Behcet's syndrome. Even in cases of nonspecific ileocolitis, the diagnosis of Behcet's colitis could be made in a significant number of cases as time goes by.
Adolescent
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Adult
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Behcet Syndrome/classification/*diagnosis/pathology
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Chi-Square Distribution
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Colitis, Ulcerative/*pathology
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Female
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Humans
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Male
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Middle Aged
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Retrospective Studies
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Time Factors
6.Behcet's Syndrome in Korea: A Look at the Clinical Picture.
Hyung Joo KIM ; Dong Sik BANG ; Seung Hun LEE ; Dong Soon YANG ; Duck Hyun KIM ; Kwang Hoon LEE ; Sungnack LEE ; Hong Bock KIM ; Won Pyo HONG
Yonsei Medical Journal 1988;29(1):72-78
Behcet's syndrome is being detected increasingly in Korea. To collect and document information concern- ing the clinical picture as it is records of patients seen in our clinic in the period between November 1983 and March 1986 were used as source material. In summary, it was found that (1) the total number of patients who had two majors symptoms at least were 410, including 170 men and 240 women; (2) Patients in their thirties were the most common, the mean age being 34.6 years; (3) according to Lehner's classification, the order of frequency of the different types was mucocutaneous (52%), ocular (33), arthritic (14%) and neurologic (1%) and according to Shimizu's classification, it was incomplete (39%), suspected (37%), and complete (24%); (4) oral ulcers, which had observed in 407 patients were the most frequent major symptom, followed by genital ulcers in 338 patients.
Adolescent
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Adult
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Age Factors
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Aged
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Behcet Syndrome/classification/diagnosis/*epidemiology
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Child
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Epidemiologic Methods
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Female
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Human
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Korea
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Male
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Middle Age
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Seasons
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Sex Factors