TOPIC: Pulmonary Vascular Disease
TYPE: Original Investigations
PURPOSE: To study the incidence of vascular disorders and to estimate their contribution to the severity and prognosis of Behcet’s disease (BD).
METHODS: Ninety-five patients with evident BD, followed up at Research Institute of Rheumatology, Russian Academy of Medical Sciences, in the January 2006 to October 2009, were examined. Their mean age was 29,7 years; male:female ratio was 3,7. The onset of the disease was chiefly at the age of 21—30 years in 36,8% of the patients. Vascular pathology was evaluated by the following techniques: vascular duplex scanning; brain magnetic resonance imaging in the mode of venosinusography, contrast-enhancement chest computed tomography, chest and abdominal angiography.
RESULTS: Vascular diseases were diagnosed in 26,3% of the patients. The venous bed was mainly involved (88%), the proportion of patients with arterial pathology was 12%. Vascular death occurred in 2 men aged 20 and 18 years due to pulmonary artery rupture aneurysm and brain sagittal sinus thrombosis. Assessment of an association of vascular disorders with other clinical manifestations of BD revealed their correlation with erythema nodosum and epididymitis. The risk for vascular events in erythema nodosum was 5 times greater (OR=5,03; 95% CI 1,54—17,41), the risk was higher in men than that in women (OR=7,11; 95% CI 1,83—30,02 versus OR=2,15; 95% CI 0,16—61,38). The male vascular risk is associated with epididymitis (OR=6,71; 95% CI 1,25—39,89). In erythema nodosum concurrent with epididymitis, the relative vascular risk was increased up to 21; 95% CI 2,15—503,94.
CONCLUSIONS: Vascular disorders in BD were diagnosed in one fourth of the patients, mainly in young male patients. Severe thromboses with the development of chronic venous insignificance, Budd—Chiari syndrome, pulmonary and iliac artery aneurysms, and arterial thromboses were observed in male patients only. Vascular events were associated with erythema nodosum and epididymitis; in these concomitances, the vascular risk was substantially increased. Vascular death rates were 2,2%.
CLINICAL IMPLICATIONS: Vascular events were associated with erythema nodosum and epididymitis; in these concomitances, the vascular risk was substantially increased. The vessel involvement was cause of mortality in yung pts.
DISCLOSURES: No relevant relationships by Zemfira Alekberova, source=Web Response
No relevant relationships by Regina Goloeva, source=Web Response
no disclosure on file for Pavel Owcharov;
No relevant relationships by Tatiana Popkova, source=Web Response
© 2021 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.