難治性口腔咽頭潰瘍3例

概要

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We encountered 2 patients who were tentatively diagnosed as having intestinal Behcet's disease during treatment for refractory oral/pharyngeal ulcers, and 1 patient with Crohn's disease. Case 1 was an 83-year-old male. Among the primary symptoms of Behcet's disease, recurrent ulcers of the oral mucosa and vulval ulcer were observed. As an accessory symptom, digestive lesions were detected. A tentative diagnosis of intestinal Behcet's disease was made according to the diagnostic criteria established by the Ministry of Health, Labour and Welfare. Case 2 was an 81-year-old female. Emergency surgery for two perforations in the small intestine was performed, but the patient died. Among primary symptoms of Behcet's disease, recurrent ulcers of the oral mucosa was noted. As an accessory symptom, digestive lesions were detected, leading to a tentative diagnosis of intestinal Behcet's disease. Case 3 was a 22-year-old male. Endoscopy of the large intestine revealed digestive lesions and stones, suggesting Crohn's disease. In all patients, the initial symptoms were oral/pharyngeal ulcers, and digestive lesions appeared. The maximum interval from onset until diagnosis was 8 months. Intestinal Behcet's and Crohn's diseases are difficult to differentiate from oral/pharyngeal mucosal lesions. Endoscopy of the digestive tract may be useful.