ARTERIAL INVOLVEMENT IN BEHCET’S DISEASE : a series of 7 cases.

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Sonia Ketari Jamoussi
Hatem Chaaba
Besma Ben Dhaou
Fatma Boussema
Samir Kochbati
Ouahida Cherif
Lilia Rokbani

Abstract

Background : Arterial involvement is rarely described in Behcet disease BD and it is associated with poor prognosis.
Aim: We report our experience with a rare and interesting subset of Behcet disease patients with arterial involvement : thrombosis and aneurysm formation types of angio-BD.
Methods: From 1994 to 2008, seven cases of arterial BD with 3 aneurysm formation and 4 thrombosis were found amongst BD patients in the department of internal medicine of Habib Thameur Hospital.
Results: Combination of venous and arterial manifestations occurred in 4 patients. All patients were male and the mean age when arterial involvement manifested was diagnosed was about 39.3. The artery most often affected is the aorta followed by the pulmonary arteries. Brain infraction occurred in about 4 cases.
Pericarditis and neurological symptoms were more frequently noted in patients with arterial BD than others without vasculo-Behcet disease. All patients underwent corticosteroids and immunosuppressive therapy. Two patients were successfullyoperated for aneurysms. All patients were alive after a mean of 7.8
years follow-up.
Conclusion: Arterial involvement is more frequently noted in vasculo-Behcet than venous thrombosis and it’s associated with a high morbidity and mortality rate.

Keywords:

Behcet's disease, Arteritis

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References

  1. Koç Y, Gullu I, Akpek G et al. Vascular involvement in Behcet's disease. ] Rheumatol 1992; 19: 402-410.
  2. Le Thi Huong D, Wechsler B, Papo T et al. Arterial lesions in Behçet's disease. J Rheumatol 1995;22:2103-13 A study in 25 patients.
  3. Houman Mh, Ben Ghorbel I, Khiari Ben Salah I et al. Deep vein thrombosis in Behçet's disease. Clin Exp Rheumatol 2001;19(5 Suppl 24):S48-50.
  4. Tazi Mezalek Z, Sahnoune I, Essalmi L et al. Deep vein thrombosis in Behçet's disease in Moroccan patients. In: Yazici H, Direskeneli H, Hamurydan V, Melikoglu M, Ozdogan H, Yavuz S, editors. 11th International Congress on Behçet's disease. Book of abstracts. Antalya. 2004 (S-109)
  5. Hamzaoui B'chir S, Harmal A, Bouslama K et al. La maladie de Behçet en Tunisie. Etude clinique de 519 cas. Rev Med interne 2006 ;22 ;742-750.
  6. Hamza M. Large artery involvement in Behçet's disease. J Rheumatol 1987; 14: 554-9.
  7. Tohmé A, Aoun N, El-Rassi B et al. Vascular manifestations of Behçet's disease: 18 cases among 140 patients. Rev Rhum. 2003; 70: 766-772
  8. Sarica-Kucukoglu, Akdag-Kose A, Kayabali M et al. Vascular involvement in Behçet's disease: a retrospective analysis of 2319 cases. Int J Dermatol. 2006; 45: 919-21.
  9. Bensaid Y, Ameur A, Kabiri H et al B. Les complications artérielles de la maladie de Behçet. A propos de 13 cas. J Mal Vasc 1997;22:24-28
  10. Turki S, Ben Taarit C, Goucha R et al. L'atteinte artérielle de la Maladie de Behçet . Rev Med Int 2001;22 (Suppl1):102S
  11. Lakhanpal S, Tani K, Lie JT et al. Pathologic features of Behçet's syndrome. Hum Pathol. 1985; 16: 790-5
  12. Hamza M. Maladie de Behçet. 4th ed. In: Kahn MF, Peltier AP, Meyer O, Piette JC,editors. Maladies et syndromes systémiques. Paris : Flammarion Médecine-Sciences; 2000. : 883-924
  13. Asli B, Wechlser B, Duhaut P et al. Manifestations artérielles de la maladie de Behçet: à propos de 63 cas. Rev Med Int 2002;23 (Suppl5) :577S
  14. Ko Gy, Byun Jy, Choi Bg et al. The vascular manifestations of Behçet's disease: angiographic and CT findings. Br J Radiology 2007; 3:1270-74.
  15. Tuzun H, Besirli K, Sayin A et al. Management of aneurysms in Behçet's syndrome: An analysis of 24 patients. Surgery 1997;121:150-6.
  16. Hamzaoui A, Hamzaoui K. Manifestations thoraciques des maladies de Behçet et de takayasu. Rev Mal Resp 2005;22:999- 1019.
  17. Iscan Zh, Vural Km, Bayazit M. Compelling nature of arterial manifestations in Behçet's disease. J Vasc Surg 2005;41:53-58.
  18. Basaran M, Sever K, Kafali E et al. The vascular manifestations of Behçet's disease: a case report. Ann Card Angiol 2004; 54:86- 88
  19. Taberkant M, Chtata H, Lekehal B et al. Anévrysme de l'aorte abdominale au cours de la maladie de Behçet: A propos de 4 cas. J Mal Vasc 2003;28:265-268.
  20. Al-Basheer M, Hadadin F. Aneurysm Formation Type of Vasculo- Behçet's Disease. Heart, Lung and Circulation 2007;16:407-9.
  21. Sraieb T, Ben Romdhane N, Longo S et al. Anévrysmes artériels et maladie de Behçet: à propos de trois cas. Rev Med Interne 1999;20:517-21.
  22. Zidi A, Ben Miled Mrad K, Hantous S et al. Angio-Behçet à localisation thoracique. J Radiol 2006;87:285-9.
  23. Erkan F, Gül A, E Tasali E: Rare diseases. Pulmonary manifestations of Behçet's disease. Thorax 2001; 56: 572-8
  24. Kieffer E, Chiche L, Bertal A et al. Anévrysmes inflammatoires de l'aorte thoracique. Arch Mal C?ur 1997;90:1751-8.
  25. Evereklioglu C. Current Concept in the Etiology and Treatment of Behçet Disease. Survophthal 2005;50:297-350
  26. Sakane T, Takeno M, Suzuki N et al. Current concepts: Bechet's disease. N Engl J Med 1999; 341: 1284-91
  27. Kaklamani Vg, Vaiopoulos G, Kaklamani PG. Behçet's disease. Semin Arthritis Rheum 1998;27:197-217.
  28. Sakane T, Takeno M. Novel approches to Behçet's disease. Exp Opin inves Drugs 2000;9:1993-2005.
  29. Evereklioglu C. Managing the symptoms of Behçet's disease. Exp Opin pharmacother 2007;5:317-28.
  30. Seyahi E, Hamuryudan V, Hatemi G et al. Infliximab in the treatment of hepatic vein thrombosis (Budd-Chiari syndrome) in three patients with Behçet's syndrome. Rheumatology 2007;46:1213-1214.
  31. Kwon Kb, Shim Wh, Yoon YS et al. Endovascular therapy combined with immunosuppressive treatment for pseudoaneurysms in patients with Behçet's disease. J Endovasc Ther 2003;10:75-80.
  32. Bozkurt Ak. Embolisation in Behçet's disease. Thorax 2002;57:469-70
  33. Hama Y, Kaji T, Iwasaki Y et al. Endovascular management of multiple arterial aneurysms in Behçet's disease. Br J Radiol 2004;77:615-9.
  34. Houman Mh, Smiti-Khanfir M, Hamzaoui K. Traitements actuels et perspectives thérapeutiques dans la maladie de Behçet. Prss Med 2008;37:25-35.