Anticoagulation of Behcet’s Disease with Thrombosis: A Series of 28 Cases in a Tertiary Care Centre in Saudi Arabia
American Journal of Internal Medicine
Volume 5, Issue 4, July 2017, Pages: 57-60
Received: Mar. 30, 2017; Accepted: Apr. 24, 2017; Published: Jun. 15, 2017
Views 2151      Downloads 121
Authors
Muneerah Albugami, Medicine Department, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
Ahmed Al Shaikh, Medicine Department, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
Abdulaziz Alrashed, Medicine Department, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
Hanan Al Hamzi, Medicine Department, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
Alanoud Khuthaila, Research Centre, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
Abdelazeim Elamin, Medicine Department, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
Mumin Siddiquee, Medicine Department, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
Usamah El Alem, Medicine Department, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
Lama Amer, Medicine Department, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
Yasmin Altwaijri, Research Centre, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
Article Tools
Follow on us
Abstract
Behcet’s disease (BD) is a multisystemic inflammatory disorder of unknown etiology. There is few data about BD in Saudi Arabia. This is a retrospective chart review study of 28 patients of BD with thrombosis on long term anticoagulation. A total of 28 BD patients, their mean age was 43.8 (25-60) years. The mean age of first thrombosis was 29.2 (14-42) years. Provoked thrombosis was reported in 17.86% of the patients. The commonest site of thrombosis was superficial femoral vein 35.71%, followed by popliteal vein 32.14%, pulmonary embolism (PE) 32.14%. Anti B2 glycoprotein 1 antibodies was identified in 31.82% of patients, Anti cardiolipin Antibodies in 22.73%, Leiden factor V in 18.18%. Activity of the disease during thrombosis was recognized as oral ulcer 44.44%, genital ulcer 33.33%, Human leukocyte antigen-B (HLAB) was 32.14%. Thrombosis while patient on anticoagulation was reported in 32.14% of patients. Bleeding was reported in 14.29% of patients, common site of bleeding was gastrointestinal bleeding. Survival rate was 78.57% and 2 patients were died (7.14%) due to malignancy. Conclusion: Thrombosis in BD patients is male predominance, more in venous, has low mortality, frequency of thrombosis is more in the presence of thrombophilia and active BD. The prevalence of thrombophilia among BD patients is high. The presence of thrombophilia still affect the physician decision regarding the initiation and duration of anticoagulation in BD. The incidence of bleeding with long term anticoagulation is low. Further research is needed to find out the prevalence of cancer among BD in Saudis.
Keywords
Behcet’s Disease, Anticoagulation, Trombosis, Thrombophilia
To cite this article
Muneerah Albugami, Ahmed Al Shaikh, Abdulaziz Alrashed, Hanan Al Hamzi, Alanoud Khuthaila, Abdelazeim Elamin, Mumin Siddiquee, Usamah El Alem, Lama Amer, Yasmin Altwaijri, Anticoagulation of Behcet’s Disease with Thrombosis: A Series of 28 Cases in a Tertiary Care Centre in Saudi Arabia, American Journal of Internal Medicine. Vol. 5, No. 4, 2017, pp. 57-60. doi: 10.11648/j.ajim.20170504.12
Copyright
Copyright © 2017 Authors retain the copyright of this article.
This article is an open access article distributed under the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
References
[1]
Mizuki N, Meguro A, Tohnai I, et al.: Association of major histocompatibility complex class I chain-related gene A and HLA-B alleles with Behcet’s disease in Turkey. Jpn J Ophthalmol 2007; 51: 431–436.
[2]
Ando H, Mizuki. Identification of a novel HLA-B allele (B*4202) in a Saudi Arabian family with Behcet's disease. Tissue Antigens. 1997; 49 (5): 526-8. PMID: 9174150.
[3]
Hamuryudan V, Er T, Seyahi E, et al. Pulmonary artery aneurysms in Behçet syndrome. Am J Med 2004; 117: 867.
[4]
Tayer-Shifman OE. Major vessel thrombosis in Behçet's disease: the dilemma of anticoagulant therapy - the approach of rheumatologists from different countries. Clin Exp Rheumatol. 2012 Sep-Oct; 30 (5): 735-40.
[5]
Al-Dalaan AN. Behçet's disease in Saudi Arabia. J Rheumatol. 1994 Apr; 21 (4): 658-61.
[6]
Yazici Y, Yurdakul S, Yazici H. Behçet’s syndrome. Curr Rheumatol Rep 2010; 12: 429-35.
[7]
Sakane T, Takeno M, Suzuki N, Inaba G. Behçet’s disease. N Engl J Med 1999; 341: 1284-91.
[8]
Xiuhua Wu,, Guohua Li,, Xinxiang Huang,, Li Wang,, Wanli Liu, Behçet's Disease Complicated with Thrombosis-A Report of 93 Chinese Cases. Medicine (Baltimore). 2014 Dec; 93 (28): e263.
[9]
Erkan Alpsoy. New Evidence-Based Treatment Approach in Behçet's Disease. Pathology Research International. Volume 2012 (2012), Article ID 871019, 11 pages.
[10]
Sarr SA, Superior vena cava syndrome revealing a Behçet's disease. Thromb J. 2015 Jan 31; 13: 7.
[11]
Saadoun D, Wechsler B. Behcet’s disease. Orphanet J Rare Dis. 2012; 7: 20.
[12]
Calamia KT, Schirmer M, Melikoglu M. Major vessel involvement in Behcet’s disease: an update. Curr Opin Rheumatol. 2011; 23: 24–31.
[13]
R. J. Ames, A. Steuer, A. Pap, and A. M. Denman, “Thrombosis in Behcet’s disease: a retrospective survey from a single UK centre,” Rheumatology; 40 (6): 652– 655, 2001.
[14]
Emire Seyahi, MD, Melike Melikoglu, Canan Akman, Vedat Hamuryudan, Harun Ozer, Gulen Hatemi, Sebahattin Yurdakul, Hasan Tuzun, Buge Oz, and Hasan Yazici, “Pulmonary Artery Involvement and Associated Lung Disease in Behçet Disease”, Medicine 2012; 91: 35-48.
[15]
Micaela La Regina, Armen Yuri Gasparyan, Behçet’s Disease as a Model of Venous Thrombosis. Open Cardiovasc Med J. 2010; 4: 71–77.
[16]
NŞ, Salgür F, Cansu DÜ, et al. Combined thrombophilic factors increase the risk of recurrent thrombotic events in Behcet's disease. Clin Rheumatol 2010; 29: 1367–1372.
[17]
Puja Mehta, Thrombosis and Behçet’s syndrome in non-endemic regions. Is there a way around? Rheumatology (2010) 49 (11): 2003-2004.
[18]
Alibaz-Oner F, et al. Study: No benefit from anticoagulant use in Behçet’s disease. Medicine. 2015.
[19]
Giacomo Emmi, Elena Silvestri, Danilo Squatrito. Thrombosis in vasculitis: from pathogenesis to treatment. Thromb J. 2015; 13: 15.
[20]
Kural-Seyahi E, Fresko I, Seyahi N, et al. The long-term mortality and morbidity of Behçet syndrome: a 2-decade outcome survey of 387 patients followed at a dedicated center. Medicine (Baltimore) 2003; 82: 60.
[21]
Saadoun D, Wechsler B, Desseaux K, et al. Mortality in Behçet's disease. Arthritis Rheum 2010; 62: 2806.
[22]
Kaklamani VG, Tzonou A, Kaklamanis PG. Behçet's disease associated with malignancies. Report of two cases and review of the literature. Clin Exp Rheumatol. 2005 Jul-Aug; 23 (4 Suppl 38): S35-41.
[23]
Lin Y, Li G, Zheng W, Tian X, Zhang F. Behcet's disease associated with malignancy: a report of 41 Chinese cases. Int J Rheum Dis. 2014 May; 17 (4): 459-65.
ADDRESS
Science Publishing Group
1 Rockefeller Plaza,
10th and 11th Floors,
New York, NY 10020
U.S.A.
Tel: (001)347-983-5186