Long-term outcome after surgery in a patient with intestinal Behçet's disease complicated by myelodysplastic syndrome and trisomy 8. 2020

Yuki Mori, and Fumihiko Iwamoto, and Yasuaki Ishida, and Toru Kuno, and Shoji Kobayashi, and Takashi Yoshida, and Tatsuya Yamaguchi, and Tadashi Sato, and Makoto Sudo, and Daisuke Ichikawa, and Nobuyuki Enomoto
First Department of Internal Medicine, Faculty of Medicine, University of Yamanashi, Yamanashi, Japan.

Behçet's disease (BD) is a multisystem inflammatory disease of unknown origin. Rarely, BD occurs together with myelodysplastic syndrome (MDS). Interestingly, it is speculated that these are not simple coexistence but that the etiology of intestinal BD is at least partly derived from MDS itself. Furthermore, there is a relationship between MDS in patients with intestinal BD and trisomy 8. Immunosuppressive agents alone are insufficient to control MDS-associated BD, and many of these patients die of infection or hemorrhage. Surgery is considered for intestinal BD patients who are unresponsive to medical treatment or those with bowel complications such as perforation or persistent bleeding. We report a case of intestinal BD associated with MDS and trisomy 8. The patient was unresponsive to oral steroids and immunosuppressive treatment; the patient improved by surgical repair of a bowel perforation. Five years after the surgery, the patient is free of recurrence and not on medication. Our experience suggests that surgery may provide an effective therapeutic option for the treatment of MDS-related BD.

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