Dear editor，
Attached is a revised version of the manuscript entitled “Combination therapy of infliximab
and thalidomide for the refractory entero-Behcet's disease: a case report” by Yue Li, Zelong
Han, Xianfei Wang, Zhihui Mo, Wei Zhang, Aimin Li and Side Liu.
We would like to thank the reviewers for their constructive and positive comments. We
revised the original manuscript, addressing all their comments on a point-by-point basis.
Changes have been incorporated into the manuscript and are highlighted in red.
Reviewer 1:
1. Abstract: Case presentation needs to be more detailed. For example, the demographic and
clinical information should be described. The term “gastrointestinal Behcet’s disease”
needs to be mentioned in the main text, and may be removed in the Abstract, even if
defined in the main text.
As requested, we provided more detailed information in “Case presentation”, including data
about the demographic and clinical information of the patient. The term “gastrointestinal
Behcet’s disease” has been removed from the Abstract as suggested.
2. Introduction: Specific data and supporting references should be provided for “along the
ancient Silk Route”, and “with severe morbidity and considerable mortality”. Suggest
moving and incorporating the data and references described in the Discussion to the
Introduction.
The supporting references have been provided in the text, and the data described in the
Discussion have been incorporated with the Introduction, as suggested.
3. Case presentation”: You mentioned in one place that “PET/CT found multiple and flake
concentration around the jejunum and ileum”, but later that “PET/CT did not reveal
abnormal concentrations nor increased metabolism, ….”. This is unclear to me. Please
clarify.
We agree with the reviewer; the sentence was confusing and the statement has been revised
accordingly.
4. Table 1 actually is a figure.
We have converted the table into a figure.
5. Discussion should focus on the diagnosis and treatment of the disease, based on your
successful case, such as lesions to be learnt, experience to be shared and recommendation.
We have revised the Discussion as suggested, and have focused on the diagnosis and the
treatment of the disease.
6. Use abbreviations correctly. No abbreviations are needed for those terms that are not to be
used later in the main text.
We have deleted abbreviations that are not used later in the main text according to reviewer’s
advice.
Reviewer 2
- Page 5, line 11: How “the possibility of intestinal lymphoma was excluded”? No
investigation have been done to esclude an enteropathy-associated T-cell lymphoma (enteroTC or entero-RM).
The possibility of intestinal lymphoma was excluded because the patient’s medical history
was long and he did not complaint of hematochezia. A PET-CT scan did not reveal any
formation of abdominal mass nor other signs of neoplasma. Most importantly, the biopsy
specimen from the deeply ulcerated area of the jejunum did not show the presence of
lymphoma cells. Coeliac disease is more prevalent in Caucasian, but our patient is an Asian.
Meanwhile, eating wheat foods does not have obvious relation with the patient’s symptoms.
Therefore, the possibility of coeliac disease was also excluded. A revision has been made in
the main text accordingly.
- Page 6, line 7: The use of CDAI does not make sense in this case. It is even low appropriate
to assess efficacy of anti-TNFs in Crohn’s disease (endoscopic scores evaluating mucosal
healing are more accurate).
We agree with the reviewer that endoscopic scores evaluating mucosal healing are more
accurate than CDAI score to assess the efficacy of treatment in Crohn’s disease. However in
our patient, an endoscopic investigation was not conducted each time during the treatment,
making it inconvenient to adopt endoscopic scores to reflect the dynamic changes in the
patient’s condition.
- The language should be improved.
The manuscript has been re-reviewed and orthographical and grammatical errors have been
rectified.
All of the authors have read and approved the revised manuscript.
I hope that you will find the revised manuscript acceptable for publication in BMC
Gastroenterology.
Best regards,
Side Liu
Correspondence to:
Side Liu MD, PhD.
Guangdong Provincial Key Laboratory of Gastroenterology,
Department of Gastroenterology, Nanfang Hospital,
Southern Medical University, Guangzhou, 510515, China.
Phone:
+86-020-61641537,
Fax:
+86-020-87280770,
E-mail:
liyue_1989919@126.com; liuside2011@163.com