34 s 6e conf6rence intemationale sur la maladie de Behfet
C 2 2
Enthesitis in Behget's disease
M. Hamza
Behget's disease (BD) had been reported associated with ankylosing spondylitis (AS) in many cases (Dilsen et al., H a m z a et aI., Olivieri et al.). It was suggested that BD an- thropathy could be included in the spondylarthropathy group as it was established in the princeps description of Wright and Moll. However the poor frequency of AS and HLA-B27 in BD was considered for m a n y authors as an argument against this inclusion.
Actually it seems that it is possible to access to this title of nobility even without AS or HLA-B27. We observed 3 patients with enthesitis. One had painful swelling at the cal- caneal insertion of the left achilles tendon with erosion on
the radiography. Two years later he developed synovitis in the lower limbs. He had nor sacroiliitis on radiography neither HLA-B27. The 2 other patients developed inflamma- tion at the tibial tubercule insertion of the patelar tendon without sacroiliitis on radiography. Only one patient had sy- novitis in the lower limbs. According to the criteria for the classification of spondylarthropathy (Dougados et al, Amor et al.), 2 patients could be considered as spondylarthropathy and 1 patient as and undifferenciated spondylarthropathy.
Our cases confirmed the hypothesis that forms of spondy- larthropathy without AS many be seen in patients with BD.
Clinique Saint Augustin, Tunis, Tunisia
C 23
Digestive manifestations of Beh~et's disease based on a serie of 74 cases
S. Benamour, B. Zeroual, S. Bettal, L. Chaoui, A. Kabli, W. Badre, M. EI-Belhadj, A. Amraoui
Our retrospective study involves about 74 cases of Beh- 9et's disease (BD) with digestive manifestations (16.15 %) among the 458 observations of BD collected in 12 years (1981-1992) in an internal medicine department of Casa- blanca.
Most often, the syndromes were minor including abdomi- nal pain (42.06 %), disorders of the gastrointestinal tract (48 %), v o m i t i n g (24.38 %), small rectal h e m o r r h a g e (20.27 %). Episodes of mucous aphts are observed in the various segments of the gastro-intestinal tract: 2 cases of esophageal ulcer, 3 cases of gastric ulcer, 5 cases of rectal ulcer and 4 cases of anal ulcer. Among these cases, one pa- tient presented an association between esophageal and
s t o -roach ulcer with ulcerative colitis. In another case, an asso- ciation of stomach and rectal aphthosis has been observed.
The severe forms are especially represented by ulcerative colitis: 4 cases have been observed. Colonic lesions appeared in massive rectal hemorrhage or prolonged hemorrhagic diarrhea with marked deterioration of the general state.
There were no ileal lesions nor perforation. The medical treatment was sufficient in our patients.
Budd-Chiari's syndrome is rare in BD: 2 cases have been reported in our series.
Internal Medicine Department, University Hospital Ibnou Rochd., Casa- blanca, Morocco.
La Revue de Medecine Inteme
