Evaluation of Endothelial Functions in Patients With Behcet's Disease Without Overt Vascular Involvement

2012 ◽  
Vol 40 (6) ◽  
pp. 518-522 ◽  
Author(s):  
Selen Yurdakul ◽  
Vefa Asli Erdemir ◽  
Yelda Tayyareci ◽  
Ozlem Yildirimturk ◽  
Mehmet Salih Gurel ◽  
...  
Keyword(s):  
Behçet’S Disease ◽  
Behcet’S Disease ◽  
Behçet's Disease ◽  
Vascular Involvement ◽  
Behcet's Disease ◽  
Endothelial Functions

Infliximab treatment in refractory vascular Behcet’s disease: A single-center experience

Vascular ◽  
2020 ◽  
Vol 28 (6) ◽  
pp. 829-833
Author(s):  
Demet Yalçın Kehribar ◽  
Metin Ozgen
Keyword(s):  
Behçet’S Disease ◽  
Oral Anticoagulant ◽  
Behcet’S Disease ◽  
Behçet's Disease ◽  
Vascular Involvement ◽  
Infliximab Treatment ◽  
Single Center ◽  
Vascular Events ◽  
Behcet's Disease ◽  
Significant Difference

Objective This study aims to investigate the efficacy and reliability of infliximab treatment in Behcet’s disease with vascular involvement. Methods This single-center retrospective study included a total of 18 patients diagnosed with Behcet’s disease with vascular involvement who were initiated infliximab treatment after exhibiting resistance to conventional immunosuppressive treatments. Results Seventeen patients achieved remission with infliximab treatment. While 18 patients were receiving a median of 50 (IQR: 20–61) mg/day equivalent of methylprednisolone before infliximab treatment, after infliximab treatment, only four patients were receiving 4 mg/day equivalent of methylprednisolone ( p < 0.001). Only 4 patients were receiving oral anticoagulant treatment during infliximab treatment, and compared to the patients who were not receiving oral anticoagulants, there was no significant difference between the two groups according to occurrence of new vascular events. Conclusion Infliximab seems to be an effective and reliable treatment in Behcet’s disease with vascular involvement and may also allow reduced dosage or even the discontinuation of corticosteroids. The results of our study suggest that oral anticoagulant use is unnecessary in Behcet’s disease with vascular involvement. However, further long-term randomized controlled studies are needed to investigate the length of infliximab regimen, whether or not it should be discontinued, and if so, whether or not immunosuppressants should be given as maintenance after discontinuation.

scholarly journals Behcet's disease with major vascular involvement

2013 ◽  
Vol 2013 (nov08 1) ◽  
pp. bcr2013200893-bcr2013200893 ◽  
Author(s):  
L. N. Geng ◽  
D. Conway ◽  
S. Barnhart ◽  
J. Nowatzky
Keyword(s):  
Behçet’S Disease ◽  
Behcet’S Disease ◽  
Behçet's Disease ◽  
Vascular Involvement ◽  
Behcet's Disease

THU0599 PULMONARY ARTERY ANEURYSM, BUDD CHIARI SYNDROME, INTRACARDIAC AND INFERIOR VENA CAVA THROMBOSES: AN UNUSUAL CASE OF BEHÇET’S DISEASE

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 541-542
Author(s):  
S. Ousalem ◽  
S. Beaudoin
Keyword(s):  
Pulmonary Artery ◽  
Behçet’S Disease ◽  
Behcet’S Disease ◽  
Behçet's Disease ◽  
Vena Cava ◽  
Artery Aneurysm ◽  
Vascular Involvement ◽  
Budd Chiari Syndrome ◽  
Behcet's Disease ◽  
Chiari Syndrome

Background:Behçet’s disease (BD) or “Silk Road” disease is a rare multisystemic inflammatory disease of unknown etiology.Vascular involvement manifested as thrombosis, arterial aneurysm, and occlusion can carry a high mortality risk. BD can be a diagnostic conundrum with its broad array of clinical presentations.Objectives:Identifying vasculo-Behçet’s disease and its management.Methods:A 25-year-old man born in Malaysia and known for cirrhosis due to idiopathic Budd Chiari syndrome presented to the emergency room with a transient ischemic attack. An inferior vena cava (IVC) occlusive thrombus and a patent foramen ovale (PFO) were discovered. Thrombolysis, angioplasty, PFO closure, and a transjugular intrahepatic portosystemic shunt (TIPS) procedure were performed. The following year, the patient experienced numerous IVC and TIPS-associated thromboses as well as a right atrial thrombus attached to his PFO closure device, all of which were refractory to anticoagulation. A few months later, the patient suffered from an acute right anterior cerebral artery stroke, with no etiology uncovered at the time. It was later determined that the patient had experienced years of recurrent oral and genital aphthae, thereby prompting a strong clinical suspicion of BD. Six months later, after only one appointment at the rheumatology clinic during which he was prescribed colchicine, the patient presented to the hospital with hemoptysis. A computed tomography (CT) pulmonary angiogram revealed a right lower lobar pulmonary arterial aneurysm with a peripheral thrombus, a right bronchial artery dilatation, and pulmonary emboli. The patient declined anticoagulation and was sent home. Two months later, he returned to the hospital, this time with hematemesis. A repeat CT pulmonary angiogram was performed and showed an increasing pulmonary emboli burden and an enlarging aneurysm. A thrombophilia workup was negative.Results:A diagnosis of BD with pulmonary aneurysms was made and treatment was initiated with methylprednisolone pulses and monthly intravenous cyclophosphamide as recommended by the European League Against Rheumatism. A month later, there was radiological evidence of significant improvement in the burden of pulmonary emboli, an interval decrease in the aneurysm’s diameter, and resolution of the right atrial thrombus.Conclusion:BD with vascular involvement or vasculo-Behçet’s disease can affect small, medium, and large vessels of both the venous and arterial vasculatures and is thought to originate from vessel wall inflammation.Thrombi in vasculo-Behçet’s disease are typically quite adherent to the vessel walls and tend not to embolize. In this case, pulmonary arterial thrombosis burden was significantly decreased after immunosuppression alone, favoring a diagnosis of in situ thrombosis rather then thromboembolism. Moreover, pulmonary artery aneurysm, Budd-Chiari syndrome, and vena cava thrombosis, which are quite uncommon and carry the highest mortality risk in vasculo-Behçet’s, were all present in this case. Early recognition can be life-saving as immunosuppression is the first-line therapy rather than anticoagulation, which carries a significant risk of pulmonary hemorrhage in the presence of a pulmonary artery aneurysm.References:[1]Seyahi, E., Behcet’s disease: How to diagnose and treat vascular involvement. Best Pract Res Clin Rheumatol, 2016. 30(2): p. 279-295.[2]Hamuryudan, V., et al., Pulmonary artery aneurysms in Behcet syndrome. Am J Med, 2004. 117(11): p. 867-70.[3]Kobayashi, M., et al., Neutrophil and endothelial cell activation in the vasa vasorum in vasculo-Behcet disease. Histopathology, 2000. 36(4): p. 362-71.[4]Seyahi, E. and S. Yurdakul, Behcet’s Syndrome and Thrombosis. Mediterr J Hematol Infect Dis, 2011. 3(1): p. e2011026.[5]Hatemi, G., et al., 2018 update of the EULAR recommendations for the management of Behcet’s syndrome. Ann Rheum Dis, 2018. 77(6): p. 808-818Disclosure of Interests:None declared

Stroke revealing Neuro-Behçet's disease with parenchymal and extensive vascular involvement

2019 ◽  
Vol 398 ◽  
pp. 131-134 ◽  
Author(s):  
Nouha Hamza ◽  
Samia Ben Sassi ◽  
Fatma Nabli ◽  
Sonia Nagi ◽  
Maha Mahmoud ◽  
...  
Keyword(s):  
Behçet’S Disease ◽  
Behcet’S Disease ◽  
Behçet's Disease ◽  
Vascular Involvement ◽  
Behcet's Disease

Investigation of the arterial intima-media thickness in Behcet’s disease patients without vascular complaints

Vascular ◽  
2017 ◽  
Vol 26 (4) ◽  
pp. 356-361
Author(s):  
Nazım Kankilic ◽  
Aydın Aslan ◽  
Oguz Karahan ◽  
Sinan Demirtas ◽  
Ahmet Caliskan ◽  
...  
Keyword(s):  
Behçet’S Disease ◽  
Behcet’S Disease ◽  
Behçet's Disease ◽  
Intima Media Thickness ◽  
Vascular Involvement ◽  
Behcet's Disease ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Media Thickness ◽  
Arterial Intima

Objectives Behcet’s disease is a multisystemic, inflammatory disease. Various factors have been implicated in the disease, including genetics, infections, immunoglobulins, immune complexes, antibodies, and oxidative stress. However, the underlying etiopathogenesis remains unclear. Behcet’s disease can occur with or without vascular involvement. This prospective study investigated the relationship between the intima-media thickness of the major arteries, in addition to other factors affecting the disease process, in Behcet’s disease without vascular involvement. Methods Twenty-four patients (average age: 38.50 ± 10.931) without vascular involvement or any vascular complaints who were diagnosed with Behcet’s disease were included in the study. Sixteen healthy subjects (average age: 39.75 ± 7.793) were included as a control group. Demographic information and medical histories were recorded, and routine blood tests were performed in both groups. The intima-media thickness of the subclavian, axillary, femoral, and carotid arteries of all the participants were recorded using Doppler ultrasonography. The data were then subjected to intergroup statistical and correlation analyses. Results There were no significant differences between the arterial intima-media thickness values of the Behcet’s disease patients and those of the control group ( p > 0.05). However, there was a significant difference between the neutrophil–lymphocyte ratio ( p = 0.004), low-density lipoprotein ( p = 0.007), and triglyceride ( p = 0042) levels of the two groups. Significant correlations were found between intima-media thickness and neutrophil–lymphocyte ratio levels ( p = 0.012) and the disease duration ( p = 0.030). There was also a significant correlation between the intima-media thickness of the femoral artery and disease duration ( p = 0.014). Conclusions The results showed that the duration of illness had a significant effect on arterial intima-media thickness in Behcet’s disease. Blood neutrophil–lymphocyte ratio levels were also associated with increased intima-media thickness.

P 067 Vascular involvement in Behçet's disease

1993 ◽  
Vol 14 ◽  
pp. 86s
Author(s):  
F. Demirkazik ◽  
F. Balkanci ◽  
S. Cekirge ◽  
T. Tacal ◽  
I. Saatci ◽  
...  
Keyword(s):  
Behçet’S Disease ◽  
Behcet’S Disease ◽  
Behçet's Disease ◽  
Vascular Involvement ◽  
Behcet's Disease
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