[Intestinal manifestations of Behçet's disease].

Behçet's disease (BD) is a systemic vasculitis of unknown origin, characterized by recurrences of the ulcerative process in the oral cavity and on the genitals, inflammatory damage of the eyes, joints, vessels and other organs. The severity and prognosis of BD determines organ pathology. Intestinal manifestations of BD (intestinal BD) are the least studied. Its verification in BD is complicated by the variety of clinical manifestations, their similarity with inflammatory bowel diseases, the lack of informative laboratory tests, pathognomonic endoscopic and histological signs. Intestinal BD can lead to serious complications (massive bleeding, intestinal perforation and fistula formation), which can not only significantly reduce the quality of the patient's life, but also cause death. Treatment of intestinal BD is not standardized; it is mainly empirical and conducted courses. The purpose of therapy is to achieve clinical remission, healing of intestinal ulcers and prevention of surgery. The article presents a case of severe refractory intestinal BD, requiring twice emergency surgical care - removal of half and then the whole of the colon because of multiple perforations. A brief review of the literature is given and diagnostic difficulties of intestinal BD are discussed.

[Behcet's disease and associations with HLA-B5 antigen (a review of literature and the authors' findings)].

AIM: To estimate the distribution of HLA Class I (A, B) antigens in patients with Behcet's disease (BD) and the association of HLA-B5 antigen with the clinical manifestations of the disease in different ethnic and population groups in relation to gender. SUBJECTS AND METHODS: The study covered 93 patients (68 males, 25 females) from the representatives of 24 ethnicities with the verified disease. HLA Class I antigens were typed by the microlymphocytotoxic technique, by applying an antileukocytic serum kit (GISANS, Saint Petersburg). RESULTS: In patients with BD, the prevalence of HLA-B5 antigen proved to be significantly higher than that in the controls (72.0 and 21%, respectively) and to be similar in patients of different ethnicities living in the Caucasus and Transcaucasus (80-83%) while the number of HLA-B5 antigen-positive patients with BD was thrice less in the Russian population than in other BD patients (p < 0.01). There was a significant correlation of HLA-B5 antigen with ocular lesion (retinal angiitis) predominantly in male patients with BD. CONCLUSION: The prevalence of HLA-B5 antigen was higher in patients with BD than in the population-based control. The diagnostic value of this antigen is not so great, for example, in the Russian population of patients with BD. The presence of HLA-B5 antigen in the phenotype of male patients with BD may be regarded as a prognostically poor marker of development of eye diseases.

[Behcet's disease and joint affection].

AIM: To study joint pathology in patients with Behcet's disease (BD). MATERIAL AND METHODS: The trial enrolled 183 BD patients (128 males, 54females, mean age 32.0 +/- 9.8 years, age at BD onset 22.3 +/- 9.9 years, mean duration of the disease 9.5 +/- 8.9 years. RESULTS: Joint pathology occurred in 74.8% patients, in 10.9% patients the disease onset was associated with arthritis and arthralgia. 3 patients had aceptic necrosis of the head of the femur and knee joint, 3 patients--bone marrow infarction. Knee joints were affected more frequently than others (up to 40%) followed by ankle, elbow and radiocarpal and other joints. In BD duration about 10 years, none of the examinees had stage III of sacroiliitis, stage II was diagnosed only in 4 patients, stage I (suspicion)--in 9. Significant sacroillitis was not registered, bilateral sacroiliitis occurred only in 9 patients. HLA B5 was detected in 61% patients while HLA B27--only in 9.7%. CONCLUSION: The articular syndrome was seen in 3/4 of BD patients. Arthritis runs a recurrent course. Erosive arthritis, sacroiliitis and combination of the latter with HLA B27 are rare.