Intestinal Behçet disease associated with myelodysplastic syndrome accompanying trisomy 8 successfully treated with abdominal surgery followed by hematopoietic stem cell transplantation: A case report

Medicine (Baltimore). 2019 Nov;98(46):e17979. doi: 10.1097/MD.0000000000017979.

Abstract

Rationale: Intestinal Behçet disease (BD) with myelodysplastic syndrome (MDS) is a rare condition that is resistant to various immunosuppressive therapies. Several cases in which hematopoietic stem cell transplantation (HSCT) was effective for intestinal BD with MDS accompanying trisomy 8 have been reported.

Patient concerns: We report an 18-year-old female with a 7-year history of BD. Colonoscopy demonstrated a huge ulcer in the cecum. Chromosomal examination revealed a karyotype of trisomy 8 in 87% of cells. Bone marrow examination revealed dysplastic cells in multilineages.

Diagnoses: A diagnosis of intestinal BD associated with MDS accompanying trisomy 8 was made.

Interventions: The patient underwent ileocecal resection due to microperforations of ileocecal ulcers; she then underwent allogeneic peripheral blood stem cell transplantation (PBSCT) with her mother as a donor.

Outcomes: After the PBSCT, the patient's symptoms due to BD (fever, oral aphthae, abdominal pain, and genital ulcers) completely disappeared, with no severe adverse events.

Lessons: The present case demonstrates that HSCT including PBSCT might be an effective new therapeutic option for refractory intestinal BD with MDS when immunosuppressive therapy has achieved insufficient efficacy.

Publication types

  • Case Reports

MeSH terms

  • Adolescent
  • Behcet Syndrome / complications*
  • Behcet Syndrome / diagnosis
  • Behcet Syndrome / surgery
  • Behcet Syndrome / therapy*
  • Chromosomes, Human, Pair 8
  • Female
  • Hematopoietic Stem Cell Transplantation / methods
  • Humans
  • Myelodysplastic Syndromes / complications*
  • Myelodysplastic Syndromes / diagnosis
  • Trisomy / pathology*

Supplementary concepts

  • Chromosome 8, trisomy