Background: Behcet syndrome (BS) was first described by Hulusi Behcet as the presence of uveitis, oral aphthous ulcers, and genital ulcers [1]. Additionally, the musculoskeletal system, gastrointestinal tract, and nervous system may be affected by BS [2]. There is regional variation in the incidence of gastrointestinal system involvement. In Turkey, the percentage is a mere 2–4%, whereas in China, it reaches 10–30%, and in Japan it ranges from 50% to 60% [3-5].

Objectives: The Far East is the primary source of information regarding intestinal involvement in BS. Our aim is also to reveal the course of GIBS in a region where it is relatively rare but BS occurs frequently.

Methods: The multidisciplinary BS outpatient clinic’s 2910 patient records from 2010 to 2023 were scanned. The study included 2404 patients who were diagnosed with BS based on the International Criteria for Behçet’s Disease [6]. The medical records of patients diagnosed with GIBS in the multidisciplinary Behçet outpatient clinic were reviewed again. The dates of gastrointestinal system involvement, pathology results, other organ involvements, endoscopy-colonoscopy findings, and treatments received by the GIBS patients were recorded.

Results: GIBS was diagnosed in 71 out of 2404 patients (3%). The mean age of GIBS patients was 38.4±11.1 years and 56.3% of them were male. (Table 1). Abdominal pain, diarrhea, and bloody diarrhea were the most frequently observed initial symptoms. An incidence of perforation was reported in 11.3% of the patients. 69% of the patients presented iliocecal involvement (Table 1). Azathioprine was the initial treatment choice for 57.6% of the patients, while 22% received 5-amino salicylic acid as their first treatment option. Anti-TNF agents were given to 58.8% of patients in second line treatment (Table 1). Patients with gastrointestinal involvement had higher levels of pathergy positivity than those without (78.4% vs 49.3%; p:<0.001) (Table 2). Patients with gastrointestinal involvement in Behcet syndrome exhibited a higher percentage of neurological involvement in comparison to those without gastrointestinal involvement (16.9 % vs 8.4%; p: 0.011) (Table 2).

Conclusion: GIS involvement in BS varies by region. It may be beneficial to be aware of neurological involvement in GIBS patients. Prospective studies should be conducted to obtain definitive data.

REFERENCES: [1] Behçet H. Rezidivierende aphthose, durch ein virus verusachte geschwure am auge und an den genitalien. Dermatol Wochenschr. 1937;105:1152–7.

[2] Hamdan A, et al. Behçet’s disease in Lebanon: clinical profile, severity and two- decade comparison. Clin Rheumatol 2006; 25: 364-367 [PMID: 16292470 DOI: 10.1007/s10067-005-0058-4].

[3] Davatchi F, et al. Behcet’s disease: from East to West. Clin Rheumatol 2010; 29: 823-833 [PMID: 20354748 DOI: 10.1007/ s10067-010-1430-6].

[4] Ebert EC. Gastrointestinal manifestations of Behçet’s disease. Dig Dis Sci 2009; 54: 201-207 [PMID: 18594975 DOI: 10.1007/ s10620-008-0337-4].

[5] Wang LY, et al. Clinical characteristics of Behçet’s disease in China. Rheumatol Int 2010; 30: 1191-1196 [PMID: 19777242 DOI: 10.1007/s00296-009-1127-9.

[6] International Team for the Revision of the International Criteria for Behçet’s Disease (ITR-ICBD). The International Criteria for Behçet’s Disease (ICBD): a collaborative study of 27 countries on the sensitivity and specificity of the new criteria. J Eur Acad Dermatol Venereol. 2014 Mar;28(3):338-47. doi: 10.1111/jdv.12107. Epub 2013 Feb 26. PMID: 23441863.

Acknowledgements: NIL.

Disclosure of Interests: None declared.