Prognosis of intestinal Behcet's disease according to the Korean consensus-based diagnostic algorithm

Abstract Background Since the consensus-based diagnostic algorithm for intestinal Behcet’s disease (iBD) was proposed by the IBD Study Group of the Korean Association for the Study of Intestinal Diseases, there were few studies regarding the prognosis of iBD according to the diagnostic algorithm. Methods We reviewed the medical records of patients who had ileocecal ulcers with clinical impression of iBD from March 1986 to August 2019 in Seoul St. Mary’s Hospital and evaluated factors at the time of diagnosis which were related with adverse events (AEs, major operation or admission from iBD) and disease-free survival (DFS). Results Among 204 eligible patients, a total of 163 were included in the study after exclusion of 41 patients with ileocecal ulcers from other disorders. The male-to-female ratio was 1:1 and the mean age at the time of diagnosis was 48.9 ± 15.9. The number of definite, probable, suspected, and non-diagnostic iBD was 18 (11.0%), 64 (39.3%), 37 (22.7%), and 44 (27.0%), respectively. Patients with definite, probable, and suspected iBD developed more AEs compared with patients with non-diagnostic iBD (p = 0.026). After exclusion of patients with non-diagnostic iBD, univariate analysis showed accompanying haematologic disorders, haemoglobin <10 g/dl, fever, colonic involvement, and hypoalbuminemia (<3.0 g/dl) were significantly related to the development of AEs (all p < 0.05). Multivariate analysis revealed accompanying haematologic disorders, haemoglobin <10 g/dl, fever, and colonic involvement were significantly associated with development of AE (all p < 0.05). Poor DFS was significantly associated with accompanying with haematologic disorders, haemoglobin <10 g/dl, and colonic involvement (p < 0.001, p = 0.022, and p = 0.034) in univariate analysis. Only haemoglobin <10 g/dl was significant in multivariate analysis. Conclusion Patients with definite, probable, and suspected iBD have a poor prognosis compared with patients with non-diagnostic iBD. Accompanying with haematologic disorders, anaemia, fever, and colonic involvement at the time of diagnosis are poor prognostic factors in patients with iBD.