Case Report: Catheter-Directed Endovascular Thrombolysis for Refractory Cerebral Venous Sinus Thrombosis in a Patient With Behçet Disease

Background: Behçet disease (BD) is an autoimmune and vasculitic disorder. BD affects the veins more frequently than the arteries. The cerebral venous sinus thrombosis (CVST) was reported to occur in about 20% of neuro-BD. Huge dilemma exists in the treatment of CVST with BD, some of which were refractory to the standard therapy.Case Presentation: Here, we report a BD case with refractory intracranial hypertension caused by CVST which is successfully treated with catheter-directed endovascular thrombolysis. Before endovascular thrombolysis, intravenous pulse methylprednisolone combined with anticoagulant therapy was used, and resulted in limited effects.Conclusion: We conclude that catheter-directed thrombolysis may be considered for refractory CVST with BD, provided that coexistent pulmonary and cerebral artery aneurysms are ruled out.

An uncommon overlap of two common rheumatological disorders

Juvenile systemic lupus erythematosus (SLE) is a heterogeneous multisystem autoimmune disease. Kawasaki disease is a common vasculitic disorder in children that manifests with fever and mucocutaneous involvement. While overlap of childhood SLE with other rheumatological disorders has been described, it is extremely unusual in the context of Kawasaki disease. We report two children who had SLE and developed features of Kawasaki disease simultaneously, and the second child had myocarditis which could be a manifestation of Kawasaki disease rather than SLE. Two or more rheumatological diseases may coexist at the same time and one must always be vigilant.

Introduction

About 1 in 20 people develop an autoimmune disease, many of which involve the musculoskeletal system. Young women are particularly at risk, but the development at any age of symptoms such as unexplained fever, rash, polyarthritis, Raynaud’s phenomenon, or mouth ulcers should encourage serological screening for autoimmune rheumatic or vasculitic disorder. The autoimmune rheumatic diseases are a heterogeneous group of disorders characterized by clinical involvement of the joints, connective tissues, muscles, internal organs, Raynaud’s phenomenon, and cutaneous manifestations. They include a broad clinical spectrum of disease, including systemic lupus erythematosus (SLE), rheumatoid arthritis (RA), Sjögren’s syndrome, scleroderma, dermatomyositis, polymyositis, antiphospholipid syndrome (APS), and the vasculitides.

A rare coexistence of Behcet’s disease and Graves’ thyrotoxicosis in a young man: a case report

Behcet’s disease is a recurrent systemic vasculitic disorder. It manifests most commonly in the form of skin lesions, oral and genital ulcers and uveitis. Graves’ thyrotoxicosis is an autoimmune disorder characterized by excessive production of thyroid hormones. We present a case of a 41-year-old male of Turkish descent who had symptoms of arthralgia, rash, palpitations and weight loss. Bloods tests showed raised inflammatory markers and biochemical evidence of severe autoimmune thyrotoxicosis. The patient was HLA-B51-negative, and pathergy test was inconclusive. A diagnosis of Behcet’s disease was made on constellation of clinical symptoms. The patient was treated with carbimazole and prednisolone followed by azathioprine. The coexistence of Behcet’s disease and Graves’ disease in the same patient is very rare. Further studies are required to determine if there is a pathological association between these two conditions.

Beyond Cat Scratch Disease: A Case Report ofBartonellaInfection Mimicking Vasculitic Disorder

Cat scratch disease (CSD) is a bacterial disease caused byBartonella henselaeand it is mainly characterized by self-limiting lymphadenopathy in the draining site of a cat scratch or bite. We report a patient with history of fever, swelling lymph nodes, vasculitic-like skin lesions, and positivity ofBartonellaserology initially considered as expression of a disimmune disease.

Introduction

About 1 in 20 people develop an autoimmune disease, many of which involve the musculoskeletal system. Young women are particularly at risk, but the development at any age of symptoms such as unexplained fever, rash, polyarthritis, Raynaud’s phenomenon or mouth ulcers should encourage serological screening for autoimmune rheumatic or vasculitic disorder....

Henoch Schonlein Purpura Presenting with Pulmonary Haemorrhage

A young woman presented with arthralgia, a rash and dramatic haemoptysis, and renal involvement was indicated by proteinuria, haematuria and a rising serum creatinine. A systemic vasculitic disorder was suspected initially, but the diagnosis of Henoch-Schonlein purpura was established by the finding of mesangial IgA deposits on renal biopsy. Immunofluorescent study of renal biopsy material is vital to diagnosis where the clinical features of Henoch-Schonlein purpura and those of the systemic vasculitides with renal involvement prove to be indistinguishable.