Similarities and differences between Behçet's disease and Crohn's disease

Table 1 Diagnostic criteria for Behçet’s disease and Crohn’s disease

	International Study Group Diagnostic Criteria for Behçet’s disease[70]	Proposed diagnostic criteria for Crohn’s disease
		Japan Criteria[72]	Lennard-Jones Criteria[73]	Copenhagen Criteria[8]
Major findings	Recurrent oral ulcerations	A: Longitudinal ulcer B: Cobblestone-like appearance C: Noncaseating epithelioid cell granuloma	Typical diarrhea history for at least 2 mo; 1 Radiological features of CD: segmental distribution, deep ulcerations or cobblestone pattern, thickened bowel wall, coarse mucosal relief, stenotic segments and fistulae; 2 Macroscopic diagnosis by endoscopy: patchy penetrating lesions, fissuring and strictures 3 Fistulas and/or abscesses with typical intestinal disease	1 History of abdominal pain, weight loss and/or diarrhea for more than 3 mo 2 Characteristic endoscopic findings of ulceration (aphtous lesions, snail track ulceration) or cobble stoning or radiological features of stricture or cobble stoning 3 Histopathology consistent with Crohn’s disease (epitheloid granuloma of Langerhans type or transmural discontinuous focal or patchy inflammation) 4 Fistula and/or abscess in relation to affected bowel segments
Minor findings	Recurrent genital ulcerations Eye lesions Skin lesions Positive pathergy test	(1) Irregular-shaped and/or quasi-circular ulcers or aphthous ulcerations found extensively in the gastrointestinal tract (2) Characteristic perianal lesions (3) Characteristic gastric and/or duodenal lesions
Definite	Major finding plus two minor findings	1 Major finding A or B 2 Major finding C, with minor finding (1) or (2) 3 All minor findings (1), (2), and (3)	Positive findings or one positive plus the finding of granuloma	At least two of the criteria present

Table 2 Treatment options for Behçet’s and Crohn’s disease

	BD		CD
	Extraintestinal BD	Intestinal BD	Extraintestinal CD	Intestinal CD
Colchicine	S, M, A	-	-	-
Corticosteroids	All manifestations	+	All manifestations	+
Azathioprine	S, M, O, V, N	+	S	+
6-mercaptopurine	-	??	-	+
Cyclosporine A	O	-	-	-
Interferon-alpha	O, N	-	-	-
Mycophenolate Mofetil	O	-	-	-
Cyclophosphamide	O, V, N	-	-	-
Methotrexate	A, N	-	A, S	-
Sulfasalazine	A	+	A	+
Mesalazine	-	+	-	+
Anti-TNF agents	A, O, N	+	A, S, O	+

A: Arthritis; S: Skin; M: Mucosal; O: Ocular; V: Vascular; N: Neurogical Involvement; (+): Effective; (-): Non-Effective; BD: Behçet’s Disease; CD: Crohn’s disease.

Table 3 Distribution of similarities and differences in the differential diagnosis of Behçet’s disease and Crohn’s disease^{[2,3,6,8,9,14,58,60,62,68,81]}

	Behçet’s Disease	Crohn’s Disease
Gender (M/F)	4.9-0.57	2.9-0.76
Symptoms onset age (yr)	20.8-40	15-29
Average age at diagnosis (yr)	24.7-35.7	29.5-31
Oral aphtous ulcers (%)	Approximately 100	< 10
Uveitis (%)	57-69	< 10
Skin lesions (%)	61-87	< 10
Arthritis (%)	30-57	2-24.7
Gastrointestinal involvement (%)
Ileocecal area	50-94	40-83
Colon	10-15	32-50
Upper GI	1-3	4
Perianal	1-2	10-15
Intestinal complications (%)
Perforation	12.7	8.7
Fistula	7.6	24.7
Stricture	7.2	38.3
Abscess	3.3	19.6
Endoscopic Morphology	Round-oval shape,	Longitudinal ulcers with a cobblestone appearance
	Focal, solitary	(segmental and diffuse distribution)
	Volcano-shaped
	Deep ulcers
Mucosal Biopsy	Vasculitis	Granuloma
	Neutrophilic infiltration	Focal cryptitis
	Fibrinopurulent exudates	Nerve fiberhyperplasia
	Necrotic debris	Lymphoid aggregates