P0273The risk factor of gastrointestinal involvement in patient with Behcet’s disease

Abstract Background Although the results of studies vary, the incidence of gastrointestinal involvement in Behçet’s disease has been reported to range from 0% to 60%. Symptoms of gastrointestinal involvement in Behçet’s disease range from mild abdominal discomfort to severe pain, and complications such as bleeding, perforation, and fistulas may occur. Gastrointestinal involvement in Behçet’s disease can lead to serious complications, such as intestinal perforation and extensive bleeding, making it a major cause of increased morbidity and mortality. Research on risk factors associated with gastrointestinal involvement in Behçet’s disease is extremely rare, and the prognosis for some patients remains poor. Therefore, this study aimed to identify risk factors for gastrointestinal involvement in patients diagnosed with Behçet’s disease and establish a basis for patient management. Methods This is the prospective study performed in a single institution and is enrolled 57 adult patients diagnosed with Behçet’s disease who consented to the study. Gastrointestinal involvement was assessed by colonoscopy computed tomography enterography (CTE), and patients’ gastrointestinal symptoms were reviewed during outpatient visits. Patient characteristics were assessed according to gastrointestinal involvement to identify risk factors for gastrointestinal involvement. Between-group comparisons were performed using the Student’s t-test for continuous variables and the Chi-square test for categorical variables. Logistic regression analysis was used to analyze risk factors. Results A total of 57 patients were included in the study. Gastrointestinal involvement was confirmed by endoscopy in 9 patients (15.8%) and by CTE in 4 patients (7.1%). Risk factors for abnormal findings on endoscopy included hematochezia/melena (p = 0.02), increased ESR (p = 0.001), DAIBD score (p 0.001), moderate or higher activity using DAIBD (p 0.001), and BDCAF score (p 0.001). Risk factors for abnormal findings on CTE included diarrhea (p 0.001), decreased albumin (p = 0.001), DAIBD score (p 0.001), moderate or higher activity using DAIBD (p 0.001), and BDCAF score (p = 0.013). The severity of Behcet’s disease (BDCAF score) at the time of examination and the serological test values ​​of DAIBD, ESR, and albumin were identified as risk factors for intestinal Behcet’s disease. Conclusion Even in patients with mild abdominal symptoms, gastrointestinal involvement may be present. In patients with severe Behçet’s disease, abnormalities in serologic tests, or a high DAIBD score, gastrointestinal involvement should be evaluated and appropriate management, including medication adjustments, should be implemented. References: 1) Chung MJ, Cheon JH, Kim SU et al.: Response rates to medical treatments and long-term clinical outcomes of nonsurgical patients with intestinal Behçet disease. J Clin Gastroenterol 2010; 44: e116-22. 2) Jung YS, Yoon JY, Hong SP, et al. Influence of age at diagnosis and sex on clinical course and long-term prognosis of intestinal Behcet’s disease. Inflamm Bowel Dis 2012; 18:1064–1071. Conflict of interest: Prof. Dr. Park, Jinhwa: No conflict of interest Park, Suhyun: No conflict of interest Byeon, Jeong-Sik: - Clinical study grants from Olympus Co, GC genome, Pharmbio Korea Inc, and Taejoon Pharm. Clinical studies related to the grants include artificial intelligence endoscopy for colon polyp detection/diagnosis, cfDNA for colorectal cancer screening, and colonoscopy bowel preparation. - I am a medical advisor of AINEX corporation, Korea, which is an AI endoscopy company.