Document Type : Case Report
Authors
1 Cardiologist, Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
2 Assistant Professor, Cardiac Rehabilitation Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
Abstract
BACKGROUND: Behçet's disease (BD) is a rare condition with a classic triad of oral and genital ulceration and eye disease. Cardiovascular complication is a rare finding in BD. CASE REPORT: In this report, we present a seventeen years old patient with a history of fever for 20 days, who developed a clot in right ventricle (RV). Cardiac magnetic resonance imaging (MRI) and echocardiography demonstrated a thrombosis in RV and a thoracic multi detector computed tomographic image showed pulmonary thromboembolism (PTE) in patient. The patient was administered with methylprednisolone, cyclophosphamide and anticoagulant. A regular follow-up was carried out. Two months later, the RV clot had disappeared on transthoracic echocardiography (TTE). CONCLUSION: In BD, early cardiac MRI and echocardiography should be performed for the detection of cardiac involvement, and medical treatment is the first choice of treatment.
Keywords
- Khammar Z, Berrady R, Boukhrissa A, Lamchachti L, Amrani K, Rabhi S, et al. Intracardiac thrombosis in Behcet disease: Clinical presentation and outcome of three cases. J Mal Vasc 2011; 36(4): 270-3.
- Darie C, Knezinsky M, Demolombe-Rague S, Pinede L, Perinetti M, Ninet JF, et al. Cardiac pseudotumor revealing Behcet's disease. Rev Med Interne 2005; 26(5): 420-4.
- Behcet H. Uber rezidivierende aphtose, durch ein virus verursachte Geschwure am Mund, am Auge und an den Genitalien. Dermatol Wochenschr 1937; 105: 1152-7.
- Criteria for diagnosis of Behcet's disease. International Study Group for Behcet's Disease. Lancet 1990; 335(8697): 1078-80.
- Wechsler B, Du LT, Kieffer E. Cardiovascular manifestations of Behcet's disease. Ann Med Interne (Paris) 1999; 150(7): 542-54.
- Baykan M, Celik S, Erdol C, Baykan EC, Durmus I, Bahadir S, et al. Behcet's disease with a large intracardiac thrombus: A case report. Heart 2001; 85(4): E7.
- Mogulkoc N, Burgess MI, Bishop PW. Intracardiac thrombus in Behcet's disease: A systematic review. Chest 2000; 118(2): 479-87.
- Akar N. Site specific mutagenesis: Usage for the mutation detection in thrombosis. Turk J Haematol 1998; 15: 123-4.
- Kiraz S, Ertenli I, Ozturk MA, Haznedaroglu IC, Celik I, Calguneri M. Pathological haemostasis and "prothrombotic state" in Behcet's disease. Thromb Res 2002; 105(2): 125-33.
- Gul A, Ozbek U, Ozturk C, Inanc M, Konice M, Ozcelik T. Coagulation factor V gene mutation increases the risk of venous thrombosis in behcet's disease. Br J Rheumatol 1996; 35(11): 1178-80.
- Haznedaroglu IC, Dundar S, Kirazh S. Eicosanoids in the prethrombotic state of Behcet's disease. Thromb Res 1995; 80(5): 445-6.
- Ames PR, Steuer A, Pap A, Denman AM. Thrombosis in Behcet's disease: A retrospective survey from a single UK centre. Rheumatology (Oxford ) 2001; 40(6): 652-5.
- Koc Y, Gullu I, Akpek G, Akpolat T, Kansu E, Kiraz S, et al. Vascular involvement in Behcet's disease. J Rheumatol 1992; 19(3): 402-10.
- Hammami S, Mahjoub S, Ben-Hamda K, Brahem R, Gamra H, Ben Farhat M. Intracardiac thrombus in Behcet's disease: Two case reports. Thromb J 2005; 3: 9.
- Buge A, Escourolle R, Chomette G, Rancurel G, Dechy H, Hauw JJ, et al. Behcet's disease with neurologic manifestations and endocardial fibrosis of the right heart. Anatomoclinical study of a case. Ann Med Interne (Paris) 1977; 128(5): 411-9.
- Marc K, Iraqui G, Jniene A, Benamor J, Bourkadi JE. Intracardiac thrombus and pulmonary artery aneurysm in Behcet's disease. Rev Mal Respir 2008; 25(1): 69-72.
- Sayin AG, Vural FS, Bozkurt AK, Oz B, Uygun N. Right atrial thrombus mimicking myxoma and bilateral pulmonary artery aneurysms in a patient with Behcet's disease-a case report. Angiology 1993; 44(11): 915-8.
- Houman M, Ksontini I, Ben Ghorbel I, Lamloum M, Braham A, Mnif E, et al. Association of right heart thrombosis, endomyocardial fibrosis, and pulmonary artery aneurysm in Behcet's disease. Eur J Intern Med 2002; 13(7): 455.
- Louali FE, Tamdy A, Soufiani A, Oukerraj L, Omari D, Bounjoum F, et al. Cardiac thrombosis as a manifestation of Behcet syndrome. Tex Heart Inst J 2010; 37(5): 568-71.
- Gopathi S, Hurt RT, Guardiola J. Intracardiac thrombus in Behcets disease: A rare case in the United States. Respir Med CME 2011; 4(4): 154-6.
- Fekih M, Fennira S, Ghodbane L, Zaouali RM. Intracardiac thrombosis: Unusual complication of Behcet's disease. Tunis Med 2004; 82(8): 785-90.
- Noureddine M, Charei N, Drighil A, Chraibi N. Right intracardiac thrombus in Behcet's disease. Arch Mal Coeur Vaiss 2004; 97(9): 925-8.
- Sacre K, Ducrocq G, Hernigou A, Laissy JP, Papo T. Unusual cardiovascular events in Behcet's disease. Clin Exp Rheumatol 2010; 28(4 Suppl 60): S82-S85.
- Vanhaleweyk G, el-Ramahi KM, Hazmi M, Sieck JO, Zaman L, Fawzy M. Right atrial, right ventricular and left ventricular thrombi in (incomplete) Behcet's disease. Eur Heart J 1990; 11(10): 957-9.
- Islim IF, Gill MD, Situnayake D, Watson RD. Successful treatment of right atrial thrombus in a patient with Beh,cet's disease. Ann Rheum Dis 1994; 53(8): 550-1.
)