Abstract
Intestinal Behçet’s disease and Crohn’s disease share a clinical presentation of intestinal ulcers, as well
as extra-intestinal manifestations such as oral aphthous ulcers, nodular erythema, and arthritis. We present a
case who was difficult to distinguish between the two diseases. In addition, we discussed the differences of
clinical features of them. The patient is 13-year-old girl. She initially had presented with fever, diarrhea, oral
aphthous ulcers, nodular erythema of legs, and knee joint swelling. Gastrointestinal endoscopy revealed
multiple ulcers, and histopathological examination showed nonspecific inflammatory cell infiltration.
HLA-B51 testing had showed a positive result, and she had been diagnosed with intestinal Behçet’s disease.
Although the symptoms improved after treatment with prednisolone, she developed a relapse accompanied
with endoscopic histopathological findings of longitudinal ulcers, a cobblestone appearance of the mucosa,
and non-caseating granuloma leading to a diagnosis of Crohn’s disease. We could not exclude the possibility
that an allergic reaction to mesalazine altered her treatment course. We speculated that she initially had
been diagnosed as intestinal Behçet’s disease for the evidences of no specific endoscopic findings of Crohn’s
disease, extra-intestinal manifestations like as Behçet’s disease, HLA-B51 positive, and failure to reduce
temperature by nutritional therapy. We suppose that Crohn’s disease seemed like as intestinal Behçet’s
disease from the confusing clinical features.
