Journal List > J Rheum Dis > v.21(6) > 1064148

TOOLS
Yoon, Cho, Lee, Choi, Lee, and Yoo: A Case of Behçet's Disease with Both Esophageal and Pharyngeal Ulcers Successfully treated with Steroid and Sulfasalazine
Case Report

J Rheum Dis 2014;21(6):311-313.

Published online: 31 October 2014

DOI: https://doi.org/10.4078/jrd.2014.21.6.311

A Case of Behçet's Disease with Both Esophageal and Pharyngeal Ulcers Successfully treated with Steroid and Sulfasalazine

Ha Yong Yoon, In Jin Cho, Hyun Lee, Yun Jung Choi, Won Seok Lee, Wan-Hee Yoo

Division of Rheumatology, Department of Internal Medicine, Chonbuk National University Medical School and Research Institute of Clinical Medicine of Chonbuk National University Hospital-Chonbuk National University, Jeonju, Korea

Corresponding to: Wan-Hee Yoo, Division of Rheumatology, Department of Internal Medicine, Chonbuk National University Medical School and Research Institute of Clinical Medicine of Chonbuk National University Hospital-Chonbuk National University, San 2-20 Geumam-dong, Deokjin-gu, Jeonju 561-180, Korea. E-mail: ywhim@jbnu.ac.kr

Received 15 June 2013       Revised 12 December 2013       Accepted 3 January 2014

Copyright © 2014 The Korean College of Rheumatology

This is a Free Access article, which permits unrestricted non-commerical use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Behçet's disease is a heterogeneous disease that involves variable organ systems. Gastrointestinal Behçet's disease is rare and it generally affects the terminal ileum with propagation toward the cecum and ascending colon. Therefore, esophageal ulcer associated with Behçet's disease has not been reported frequently. We report an unusual case of Behçet's disease associated with both esophageal and pharyngeal ulcers. A 64-year-old man was admitted for an evaluation of pharyngeal and substernal discomfort sustained for 3 months. He had no underlying chronic disease; however, he suffered from recurrent oral and genital ulcers for 20 years and had folliculitis-like skin lesions on the face, scalp and trunk. He was diagnosed with Behçet's dis ease and gastroesophageal fiberscopy revealed deep ulcers on both the pharynx and upper esophagus. Esophagopharyngeal ulcers were successfully treated with prednisolone, colchicines, dapsone, and sulfasalazine.

Keywords: Esophageal ulcer, Behçet's disease, Steroid, Sulfasalazine

REFERENCES

1. Yasuo M, Miyabayashi H, Okano T, Aoki H, Ichikawa K, Hirose Y. Successful treatment with corticosteroid in a case of Behç et's syndrome with multiple esophageal ulcerations. Intern Med. 2003; 42:696–9.
2. Yi SW, Cheon JH, Kim JH, Lee SK, Kim TI, Lee YC, et al. The prevalence and clinical characteristics of esophageal involvement in patients with Behç et's disease: a single center experience in Korea. J Korean Med Sci. 2009; 24:52–6.
3. Maruyama Y, Hisamatsu T, Matsuoka K, Naganuma M, Inoue N, Ogata H, et al. A case of intestinal Behç et's disease treated with infliximab monotherapy who successfully maintained clinical remission and complete mucosal healing for six years. Intern Med. 2012; 51:2125–9.
4. Almoznino G, Ben-Chetrit E. Infliximab for the treatment of resistant oral ulcers in Behç et's disease: a case report and review of the literature. Clin Exp Rheumatol. 2007; 25(4 Suppl 45):S99–102.
5. Sakane T, Takeno M, Suzuki N, Inaba G. Behç et's disease. N Engl J Med. 1999; 341:1284–91.
6. Lehmann H, Stutte HJ, Zierott G, Schlaak M. A case of Behcet's disease with multiple intestinal ulcerations (author's transl). Dtsch Med Wochenschr. 1975; 100:308–11.
7. Arma S, Habibulla KS, Price JJ, Collis JL. Dysphagia in Behç et's syndrome. Thorax. 1971; 26:155–8.
8. Mori S, Yoshihira A, Kawamura H, Takeuchi A, Hashimoto T, Inaba G. Esophageal involvement in Behcet's disease. Am J Gastroenterol. 1983; 78:548–53.
9. Yashiro K, Nagasako K, Hasegawa K, Maruyama M, Suzuki S, Obata H. Esophageal lesions in intestinal Behç et's disease. Endoscopy. 1986; 18:57–60.
10. Glosemeyer R, Deppe H, Dormann AJ, Wigginghaus B, Stolte M, Stadler R, et al. Ulcerative esophagitis and colitis as rare manifestations of Adamantiades-Behcet disease. Z Gastroenterol. 2001; 39:167–71.
11. Lorenzetti ME, Forbes IJ, Roberts-Thomson IC. Oesophageal and ileal ulceration in Behç et's disease. J Gastroenterol Hepatol. 1990; 5:714–7.
12. Ikezawa K, Kashimura H, Hassan M, Nakahara A, Yanaka A, Matsuzaki Y, et al. A case of Behç et's syndrome with esophageal involvement treated with salicylazosulfapyr-idine and prednisolone. Endoscopy. 1998; 30:S52–3.

Figure 1.
Pharyngeal (A) and esophageal (B) ulcers in Behcet's disease.
jrd-21-311f1.tif
Figure 2.
Histopathologic findings of ulcer lesion (A) ×200, (B) ×100.
jrd-21-311f2.tif
TOOLS
Similar articles