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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
Issue Date
Adult ; Behcet Syndrome/diagnosis* ; Behcet Syndrome/pathology ; Chi-Square Distribution ; Colon/pathology ; Colonoscopy* ; Feasibility Studies ; Female ; Humans ; Ileum/pathology ; Intestines/pathology* ; Linear Models ; Male ; Middle Aged ; Multivariate Analysis ; Peptic Ulcer/diagnosis* ; Peptic Ulcer/pathology ; Predictive Value of Tests ; Retrospective Studies ; Severity of Illness Index
Colonoscopy ; Disease activity index ; Endoscopic severity ; Intestinal Behcet's disease ; Ulcer
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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6. Others (기타) > Dept. of Health Promotion (건강의학과) > 1. Journal Papers
6. Others (기타) > Severance Hospital (세브란스병원) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Preventive Medicine (예방의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Won Ho(김원호) ORCID logo https://orcid.org/0000-0002-5682-9972
Kim, Youn Nam(김윤남)
Kim, Tae Il(김태일) ORCID logo https://orcid.org/0000-0003-4807-890X
Nam, Chung Mo(남정모) ORCID logo https://orcid.org/0000-0003-0985-0928
Park, Soo Jung(박수정)
Lee, Hyun Jung(이현정)
Jang, Hui Won(장희원)
Jeon, Han Ho(전한호)
Jung, Eun Suk(정은석)
Cheon, Jae Hee(천재희) ORCID logo https://orcid.org/0000-0002-2282-8904
Hong, Sung Pil(홍성필)
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