Histopathology of pulmonary thromboembolism in a patient with Behçet's disease

Tsukui, Daisuke; Hirohata, Shunsei; Kikuchi, Hirotoshi; Uozaki, Hiroshi; Kono, Hajime

doi:10.55563/clinexprheumatol/il4pc7

Cited by 6 publications

(7 citation statements)

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“…Previous studies have indicated that thrombus develops as a complication of the underlying endothelial dysfunction or vasculitis (52)(53)(54). An interesting report is about a post-mortem examination of a patient who apparently died from acute complete obstruction of the pulmonary arteries due to a pulmonary embolus (PE) originating from a thrombus in the inferior vena cava (55). The authors propose that this report is the ever first documentation of a histologically documented PE in BS.…”

Section: Vascular Involvementmentioning

confidence: 86%

Behçet's yndrome: one year in review 2023

Hatemi,

Seyahi,

Fresko

et al. 2023

Clinical and Experimental Rheumatology

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Section: Vascular Involvementmentioning

confidence: 86%

Behçet's yndrome: one year in review 2023

Hatemi,

Seyahi,

Fresko

et al. 2023

Clinical and Experimental Rheumatology

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“…There may be some explanations for different results. Tshumi et al showed 10 that the risk of pulmonary embolization derived from DVT may be higher than expected. Also, some previous studies reported concurrent DVT and PE 7,11–13 despite IS treatment.…”

Section: Discussionmentioning

confidence: 98%

Does anticoagulation in combination with immunosuppressive therapy prevent recurrent thrombosis in Behçet’s disease?

Erol,

Gürün Kaya,

Arslan

et al. 2024

Journal of Investigative Medicine

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Vascular involvement in Behçet’s Disease (BD) occurs in up to 50% of patients. The main mechanism of thrombosis is inflammation. Thus, immunosuppressants (IS) are the mainstay of therapy, and adding anticoagulants (AC) is controversial. In daily practice, we observed that patients who receive AC in combination with IS experience less recurrent thrombosis and decided to retrospectively investigate our Behçet's Disease patients. We hypothesized that adding anticoagulants to immunosuppressive therapy may lower the risk of recurrent thrombosis. Treatment at the time of first or recurrent thrombotic events was recorded. Events under the only IS and IS+AC treatments were compared. There were 40 patients (33 males). The most common types of first vascular events were deep vein thrombosis (77.5%) followed by pulmonary embolism (PE) (52.5%). One patient didn’t receive any treatment. Among the 39 patients, 32 received glucocorticoid and at least one of the azathioprine, or cyclophosphamide, anti-TNF, 5 received monotherapy with azathioprine, 1 received monotherapy with corticosteroid, and the remaining 1 received monotherapy with cyclophosphamide. 22 patients (55%), experienced 27 recurrent venous thromboembolism (VTE) events. 2 (7.4%) events while only on AC, 2 (7.4%) events while on AC+IS, and 15 (55.5%) events occurred while on only IS. 8 (19.6%) patients were not receiving any treatment during relapses. The recurrence rate was statistically significantly lower in the IS+AC treatment group compared to IS alone. In conclusion, immunosuppressants are the mainstay of treatment for BD, adding anticoagulants may help to lower the recurrence risk of thrombotic events.

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“…Inflammation, which is thought to be the cause of increased wall thickness in vessels, is more prominent in veins than in arteries in BD cases [ 17 ]. Moreover, in cases presenting BD compared with arterial involvement, venous involvement affects the intimal layer and may cause significant changes in the vessel wall [ 17 , 31 ]. However, information regarding the histopathology of the venous involvement in BD is limited.…”

Section: Discussionmentioning

confidence: 99%

“…In an autopsy series, three patients with BD and venous involvement exhibited intimal fibrous thickening and mild cellular infiltration in the vessel wall. In another autopsy study, one patient with BD and pulmonary thrombosis presented with thrombus covering a thickened fibrous intima and inflammatory cell infiltration mainly between the intima and thrombus [ 31 ]. In cases of BD, although there is no histological evidence, it has been reported that venous inflammation, which may cause endothelial dysfunction and a thrombosis tendency, may increase the venous wall thickness [ 10 ].…”

Section: Discussionmentioning

confidence: 99%

Measuring the Whole Wall Thickness of the Common Femoral Vein as a Distinctive Diagnostic Tool to Distinguish Behçet’s Disease Presenting with Oral Ulcers from Recurrent Aphthous Stomatitis

Erturk,

Sarıkaya,

Coşkun

et al. 2023

Diagnostics

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Recurrent oral ulcers, which are the first and most common manifestation of Behçet’s disease (BD), have several etiological causes but are often idiopathic and known as recurrent aphthous stomatitis (RAS). In recent years, publications have drawn attention to the fact that whole-wall thickness (WWT) and intima–media thickness (IMT) measurements of the common femoral vein (CFV) may be useful in the diagnosis of BD, which are independent of organ involvement. In this study, the usefulness of the WWT and IMT of the CFV measured by venous Doppler ultrasound (US) was investigated in differentiating BD presenting with oral ulcers from RAS. Patients with BD (n = 84), patients with RAS (n = 85), and healthy controls (HCs) (n = 70) were the three groups included. Both the right and left WWT of the CFV were significantly higher in the BD compared with the HCs and RAS groups (p < 0.001). The diagnostic cutoff values of ≥0.58 mm for the WWT of the CFV performed well against both the patients with RAS and HCs for the discrimination of BD (sensitivity = 79.8%, specificity = 64.7%). In patients with recurrent oral ulcers, the WWT of the CFV measurement may be a distinctive new diagnostic tool for the differential diagnosis of BD and RAS.

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Histopathology of pulmonary thromboembolism in a patient with Behçet's disease

Cited by 6 publications

References 0 publications

Behçet's yndrome: one year in review 2023

Behçet's yndrome: one year in review 2023

Does anticoagulation in combination with immunosuppressive therapy prevent recurrent thrombosis in Behçet’s disease?

Measuring the Whole Wall Thickness of the Common Femoral Vein as a Distinctive Diagnostic Tool to Distinguish Behçet’s Disease Presenting with Oral Ulcers from Recurrent Aphthous Stomatitis

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