Behçet’s syndrome, Crohn’s disease and toxic megacolon

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Behçet’s syndrome is characterized by a triad of symptoms: recurrent oral and genital ulcerations, and ocular inflammation. Since the first report by Behçet in 19371 similar cases have been described, and it is now acknowledged that this disorder has a wide spectrum of clinical manifestations.2–4

The gastrointestinal involvement in this disease was first described by Bechgaard5 in 1940, and since then several reports have been published.6–9 The literature on Behçet’s disease has been extensively reviewed.10–13

This report describes a case of Behçet’s disease associated with Crohn’s disease of the colon and terminal ileum complicated by toxic megacolon. To our knowledge such a combination has not been described previously.

Case report*

A 15-year-old Caucasian girl was first seen at the Cleveland Clinic in 1950, when a diagnosis of grand mal and petit mal epilepsy was made. She was treated with diphenylhydantoin and phenobarbital; on this regimen she had fewer than seven seizures a year. On several occasions she complained of severe pain in the hips, legs, and ankles. By 1959 the electroencephalogram had returned to an almost normal pattern. However, the number of seizures increased in November 1963 and the patient complained of fever, malaise, and diffuse skeletal aching.

In June 1964 she noticed some clumsiness of her movements. Physical examination revealed mild slurring of speech, coarse horizontal nystagmus greater to the right, mild vertical nystagmus, truncal ataxia, dysmetria of the upper extremities, and positive Romberg test. She had synovitis, and limited movement of elbows, ankles, knees, and . . .



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