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Correlations between endoscopic and clinical disease activity indices in intestinal Behcet's disease

 Hyun Jung Lee  ;  Youn Nam Kim  ;  Hui Won Jang  ;  Han Ho Jeon  ;  Eun Suk Jung  ;  Soo Jung Park  ;  Sung Pil Hong  ;  Tae Il Kim  ;  Won Ho Kim  ;  Chung Mo Nam  ;  Jae Hee Cheon 
 World Journal of Gastroenterology, Vol.18(40) : 5771-5778, 2012 
Journal Title
 World Journal of Gastroenterology 
Issue Date
AIM: To develop a novel endoscopic severity model of intestinal Behcet's disease (BD) and to evaluate its feasibility by comparing it with the actual disease activity index for intestinal Behcet's disease (DAIBD). METHODS: We reviewed the medical records of 167 intestinal BD patients between March 1986 and April 2011. We also investigated the endoscopic parameters including ulcer locations, distribution, number, depth, shape, size and margin to identify independent factors associated with DAIBD. An endoscopic severity model was developed using significant colonoscopic variables identified by multivariate regression analysis and its correlation with the DAIBD was evaluated. To determine factors related to the discrepancy between endoscopic severity and clinical activity, clinical characteristics and laboratory markers of the patients were analyzed. RESULTS: A multivariate regression analysis revealed that the number of intestinal ulcers (≥ 2, P = 0.031) and volcanoshaped ulcers (P = 0.001) were predictive factors for the DAIBD. An endoscopic severity model (Y) was developed based on selected endoscopic variables as follows: Y = 47.44 + 9.04 × non-Ileocecal area + 11.85 × ≥ 2 of intestinal ulcers + 5.03 × shallow ulcers + 12.76 × deep ulcers + 4.47 × geographic-shaped ulcers + 26.93 × volcano-shaped ulcers + 8.65 × ≥ 20 mm of intestinal ulcers. However, endoscopic parameters used in the multivariate analysis explained only 18.9% of the DAIBD variance. Patients with severe DAIBD scores but with moderately predicted disease activity by the endoscopic severity model had more symptoms of irritable bowel syndrome (21.4% vs 4.9%, P = 0.026) and a lower rate of corticosteroid use (50.0% vs 75.6%, P = 0.016) than those with severe DAIBD scores and accurately predicted disease by the model. CONCLUSION: Our study showed that the number of intestinal ulcers and volcano-shaped ulcers were predictive factors for severe DAIBD scores. However, the correlation between endoscopic severity and DAIBD (r = 0.434) was weak.
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1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Biomedical Systems Informatics (의생명시스템정보학교실)
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Pharmacology (약리학교실)
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Preventive Medicine and Public Health (예방의학교실)
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실)
Yonsei Authors
김원호(Kim, Won Ho)
김윤남(Kim, Youn Nam)
김태일(Kim, Tae Il) ORCID logo https://orcid.org/0000-0003-4807-890X
남정모(Nam, Jung Mo) ORCID logo https://orcid.org/0000-0003-0985-0928
박수정(Park, Soo Jung)
이현정(Lee, Hyun Jung)
장희원(Jang, Hui Won)
전한호(Jeon, Han Ho)
정은석(Jung, Eun Suk)
천재희(Cheon, Jae Hee) ORCID logo https://orcid.org/0000-0002-2282-8904
홍성필(Hong, Sung Pil)
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