When Behçet Mimics Crohn's disease: A Diagnostic Challenge.

Area of Science:

• Gastroenterology
• Rheumatology
• Dermatology

Background:

• Ulcerative colitis (UC) and Crohn's disease (CD) are chronic inflammatory bowel diseases (IBD) with overlapping symptoms.
• Behçet's syndrome (BS) is a multisystemic vasculitis that can present with gastrointestinal, mucocutaneous, and other systemic manifestations.
• Distinguishing between IBD and BS can be diagnostically challenging due to similar clinical presentations.

Purpose of the Study:

• To report a challenging case of a patient initially diagnosed with ulcerative colitis (UC), later revised to Crohn's disease (CD), and finally diagnosed with Behçet's syndrome (BS).
• To highlight the diagnostic difficulties in differentiating BS from IBD.
• To illustrate the successful management of BS presenting with severe gastrointestinal symptoms.

Main Methods:

• Case report of a 21-year-old male of Syrian descent.
• Clinical evaluation including colonoscopy.
• Diagnostic revision based on evolving clinical manifestations.
• Treatment with prednisolone and infliximab.

Main Results:

• Initial diagnosis of UC was revised to CD based on colonoscopy findings (pancolitis sparing descending and sigmoid colon).
• Development of oral, genital, and inguinal ulcers, along with papulopustular lesions, led to a revised diagnosis of BS.
• Remission was achieved with a short course of prednisolone followed by infliximab therapy.

Conclusions:

• Behçet's syndrome can mimic inflammatory bowel diseases, posing significant diagnostic challenges.
• A high index of suspicion and careful evaluation of mucocutaneous and systemic symptoms are crucial for diagnosing BS.
• Infliximab can be an effective treatment for gastrointestinal manifestations of BS.