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.
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