The American Journal of GASTROENTEROLOGY VOLUME 104 | OCTOBER 2009 www.amjgastro.com ORIGINAL CONTRIBUTIONS nature publishing group 2492 INFLAMMATORY BOWEL DISEASE INTRODUCTION Behçet’s disease (BD) is a chronic recurrent systemic infam- matory disorder characterized mainly by ulcerations of the oral cavity and genitalia and ocular infammations. Other clin- ical involvement includes joints, skin, vessels, the central nerv- ous system, and the gastrointestinal tract (1). Epidemiological fndings imply that the development of the disease might be attributable to both genetic and environmental factors, such as HLA-B51 and microbial infections (2). However, the exact etiology has not yet been identifed. Cases of BD are common in East Asia and in Mediterranean countries, including Turkey, Japan, Korea, China, Iran, and Saudi Arabia, but the disease is relatively uncommon in the United States and Northern Europe (3,4). Te leading pathophysiologic characteristics of Development and Validation of Novel Diagnostic Criteria for Intestinal Behçet’ s Disease in Korean Patients With Ileocolonic Ulcers Jae Hee Cheon, MD, PhD 1,9 , Eun Soo Kim, MD, PhD 1,9 , Sung Jae Shin, MD, PhD 2 , Tae Il Kim, MD, PhD 1 , Kang Moon Lee, MD, PhD 3 , Sang Woo Kim, MD, PhD 3 , Joo Sung Kim, MD, PhD 4 , You Sun Kim, MD, PhD 5 , Chang Hwan Choi, MD, PhD 6 , Byong Duk Ye, MD, PhD 7 , Suk-Kyun Yang, MD, PhD 7 , Eun Hee Choi, MS 8 and Won Ho Kim, MD, PhD 1 OBJECTIVES: It is difficult to diagnose intestinal Behçet’ s disease (BD) due to various extraintestinal manifestations emerging at different time points in the disease course and a lack of reliable diagnostic criteria. We conducted this study to develop and validate novel diagnostic criteria for intestinal BD. METHODS: Experts from three universities generated the preliminary diagnostic criteria for intestinal BD, and a consensus was reached using a modified Delphi method with 13 gastroenterologists participating. To validate the criteria, we recruited 12,850 consecutive patients who underwent colonoscopic examinations between January 2000 and December 2006 at Severance Hospital, Yonsei University, Seoul, Korea. RESULTS: The novel diagnostic criteria were developed on the basis of two aspects: colonoscopic findings and extraintestinal manifestations. Of the 12,850 patients, 280 with ileocolonic ulcers were enrolled for validation. At the time of initial colonoscopic examinations, patients were categorized for BD status into 4 groups: definite (84 patients), probable (67), suspected (15), and nondiagnostic (114). At the end of the follow-up period (mean, 50.9±25.7 months), intestinal BD was confirmed in 145 patients (51.8%)—84 (100%) from the definite group, 49 (73.1%) from the probable group, 10 (66.7%) from the suspected group, and 2 (1.8%) from the nondiagnostic group. The overall sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of the diagnosis probability of these criteria were 98.6, 83.0, 86.1, 98.2, and 91.1%, respectively. CONCLUSIONS: These newly proposed, simple criteria might be useful in diagnosing intestinal BD, especially in patients with ileocolonic ulcers who do not fully satisfy the diagnostic criteria of systemic BD. Am J Gastroenterol 2009; 104:2492–2499; doi:10.1038/ajg.2009.331; published online 16 June 2009 1 Department of Internal Medicine and Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Korea; 2 Department of Internal Medicine, Ajou University College of Medicine, Seoul, Korea; 3 Department of Internal Medicine, Catholic University College of Medicine, Seoul, Korea; 4 Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea; 5 Department of Internal Medicine, Inje University College of Medicine, Seoul, Korea; 6 Department of Internal Medicine, ChungAng University College of Medicine, Seoul, Korea; 7 Department of Internal Medicine, University of Ulsan College of Medicine, Seoul, Korea; 8 Department of Biostatistics, Yonsei University College of Medicine, Seoul, Korea; 9 These authors contributed equally to this work. Correspondence: Won Ho Kim, MD, PhD, Department of Internal Medicine and Institute of Gastroenterology, Yonsei University College of Medicine, 134 Shinchon-dong, Seodaemun-gu, Seoul 120-752, Korea. E-mail: kimwonho@yuhs.ac Received 4 February 2009; accepted 29 April 2009