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Evidence-based diagnosis and clinical practice guidelines for intestinal Behçet’s disease 2020 edited by Intractable Diseases, the Health and Labour Sciences Research Grants

Authors
  • Watanabe, Kenji1
  • Tanida, Satoshi2
  • Inoue, Nagamu3
  • Kunisaki, Reiko4
  • Kobayashi, Kiyonori5
  • Nagahori, Masakazu6
  • Arai, Katsuhiro7
  • Uchino, Motoi1
  • Koganei, Kazutaka8
  • Kobayashi, Taku9
  • Takeno, Mitsuhiro10
  • Ueno, Fumiaki11
  • Matsumoto, Takayuki12
  • Mizuki, Nobuhisa13
  • Suzuki, Yasuo14
  • Hisamatsu, Tadakazu15
  • 1 Hyogo College of Medicine,
  • 2 Nagoya City University Graduate School of Medical Sciences,
  • 3 Keio University School of Medicine,
  • 4 Yokohama City University Medical Center,
  • 5 Kitasato University, School of Medicine,
  • 6 Tokyo Medical and Dental University,
  • 7 National Center for Child Health and Development,
  • 8 Yokohama Municipal Citizen’s Hospital,
  • 9 Kitasato University Kitasato Institute Hospital,
  • 10 Nippon Medical School Musashi Kosugi Hospital,
  • 11 Center for Gastroenterology and Inflammatory Bowel Disease, Ofuna Chuo Hospital, Kanazawa, Japan
  • 12 Iwate Medical University,
  • 13 Yokohama City University Graduate School of Medicine,
  • 14 Toho University Sakura Medical Center,
  • 15 Kyorin University School of Medicine,
Type
Published Article
Journal
Journal of Gastroenterology
Publisher
Springer Singapore
Publication Date
May 07, 2020
Volume
55
Issue
7
Pages
679–700
Identifiers
DOI: 10.1007/s00535-020-01690-y
PMID: 32377946
PMCID: PMC7297851
Source
PubMed Central
Keywords
License
Unknown

Abstract

Behçet's disease (BD) is an intractable systemic inflammatory disease characterized by four main symptoms: oral and genital ulcers and ocular and cutaneous involvement. The Japanese diagnostic criteria of BD classify intestinal BD as a specific disease type. Volcano-shaped ulcers in the ileocecum are a typical finding of intestinal BD, and punched-out ulcers can be observed in the intestine or esophagus. Tumor necrosis factor inhibitors were first approved for the treatment of intestinal BD in Japan and have been used as standard therapy. In 2007 and 2014, the Japan consensus statement for the diagnosis and management of intestinal BD was established. Recently, evidence-based JSBD (Japanese Society for BD) Clinical Practice Guidelines for BD (Japanese edition) were published, and the section on intestinal BD was planned to be published in English. Twenty-eight important clinical questions (CQs) for diagnosis (CQs 1–6), prognosis (CQ 7), monitoring and treatment goals (CQs 8–11), medical management and general statement (CQs 12–13), medical treatment (CQs 14–22), and surgical treatment (CQs 23–25) of BD and some specific situations (CQs 26–28) were selected as unified consensus by the members of committee. The statements and comments were made following a search of published scientific evidence. Subsequently, the levels of recommendation were evaluated based on clinical practice guidelines in the Medical Information Network Distribution Service. The degree of agreement was calculated using anonymous voting. We also determined algorithms for diagnostic and therapeutic approaches for intestinal BD. The present guidelines will facilitate decision making in clinical practice.

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