INTESTINE Vol.23 No.6(1)

特集名 全身性疾患における腸管病変─腸管ベーチェット病とその鑑別疾患
題名 腸管ベーチェット病の疫学と診断基準
発刊年月 2019年 11月
著者 久松 理一 杏林大学医学部消化器内科学
【 要旨 】 ベーチェット病は再発性口腔内アフタを含む4主徴候を特徴とする難治性全身性炎症性疾患であり,腸管ベーチェット病は特殊型として分類される.腸管ベーチェット病の診断には回盲部の内視鏡的定型病変とベーチェット病診断基準を満たすことが必要である.腸管BDの患者では時に穿孔や出血によって緊急手術が必要となり,高い術後再発率や再手術率も問題となる.内科的治療は経験的に行われてきたが,抗TNFα抗体製剤は日本で臨床試験が行われ中等症以上の標準治療として位置づけられた.日本ではコンセンサス・ステートメントが作成され新たな診療ガイドライン作成も進んでいる.
Theme Systemic disease-associated intestinal involvement -- Intestinal Behçet's disease and its differential diagnosis
Title Epidemiology and diagnostic criteria for intestinal Behçet's disease
Author Tadakazu Hisamatsu Department of Gastroenterology and Hepatology, Kyorin University School of Medicine
[ Summary ] Behçet's disease is an intractable systemic inflammatory disease characterized by four main symptoms including recurrent oral aphthous lesions. Intestinal Behçet's disease is classified as a special type. Diagnosis of intestinal Behçet's disease requires that the ileocecal endoscopic typical lesions and diagnostic criteria for Behçet's disease be met. Patients with intestinal BD sometimes require emergency surgery due to perforation or bleeding. High postoperative recurrence and reoperation rates are also problematic. Although medical treatment has been conducted empirically, clinical trials of anti-TNF antibody agents were performed in Japan and anti-TNF antibody agents have been positioned as standard treatments for moderate and severe disease. In Japan, consensus statements have been made and new medical treatment guidelines are being developed.