A case of intestinal Behçet disease in a deceased donor kidney transplantation recipient

Behçet disease (BD) is a multisystem inflammatory disorder characterized by a chronic relapsing course. Because immunosuppressive therapy is the mainstay of BD treatment, its use in transplant recipients may attenuate typical clinical manifestations, thereby complicating diagnosis. We report a case of new-onset intestinal BD that developed in a 28-year-old man 3 years after deceased donor kidney transplantation, following an episode of cytomegalovirus colitis. The patient presented with recurrent abdominal pain, diarrhea, weight loss, and hematochezia. Colonoscopy revealed a deep, oval ulcer with well-demarcated, edematous, and nodular margins in the terminal ileum as well as healed scars near the ileocecal valve, findings consistent with intestinal BD. The patient's symptoms improved after 2 weeks of therapy with colchicine, mesalazine, and mercaptopurine. This case highlights the rare, <i>de novo</i> development of intestinal BD years after kidney transplantation. Intestinal BD should be considered in transplant recipients presenting with unexplained abdominal pain or diarrhea.