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A review of records finds that thrombosis, particularly DVT, is far from a rare occurrence among patients with Behçet's disease. Advice about management is offered.
Wu X, Li G, Huang X, et al. BehÃ§et's Disease Complicated with Thrombosis: A Report of 93 Chinese Cases. Medicine 2014;28: e263 doi: 10.1097/MD.0000000000000263 December 2014
There are numerous recent reports of thrombosis in patients with BehÃ§et's disease (BD), but how common is it actually? This recent retrospective review finds it to be a common occurrence in BD patients.
Over the past 20 years, there have been 766 patients at Peking Union Medical College with BehÃ§et's disease and 9 (12%) also had a diagnosis of thrombosis, the authors report.
The most common thrombosis was DVT (84%), followed by vena cava thrombosis (30%), pulmonary thromboembolism (15%), and cerebral venous thrombosis (13%).
The thrombosis resolved in 89 patients after treatment with corticosteroids, immunosuppressants, or anticoagulants. Four patients died, from aneurysm rupture, myocardial infarction, Budd-Chiari syndrome, and septic shock, respectively.
The European League Against Rheumatism recommends glucocorticoids and immunosuppressants in managing acute DVT in BehÃ§et's disease. However, EURAL discourages antiplatelet, anticoagulant, and antifibrinolytic agents, because the tight adhesions of peripheral thrombosis to venous walls rarely results in emboli in the lungs, and anticoagulants could rupture aneurysms.
The Chinese clinicians report using aspirin and anticoagulants in patients who do not have pulmonary artery aneurysms.