Vascular Involvement in Behcet’s Disease: An Evaluation of 147 Cases and Literature Review

Objectives: Behcet’s disease (BD) is characterized by systemic vasculitis with inflammation that can affect various body organs. In BD, vasculitis primarily manifests with venous involvement, distinguishing it from other forms of systemic vasculitis.
Methods: We retrospectively analyzed the demographic and clinical characteristics of 147 patients diagnosed with vascular BD in our center.
Results: Vascular BD cases accounted for 25.0% (147 out of 589) of all BD patients. A statistically significant correlation was found between gender and vascular involvement that was seen predominantly in males (76.9%). In 71 patients, a vascular event developed during follow-up for BD, while in 76 patients the disease was diagnosed after the occurrence of a vascular event (51.7%). The most common vascular event was deep vein thrombosis in the lower extremities (69.4%). Arterial involvement was primarily observed in the pulmonary arteries (12.9%). Patients with lower extremity deep vein thrombosis tended to be younger, while those with pulmonary artery involvement were typically older. Overall, veins were affected 4.5 times more frequently than arteries.
Conclusion: The prevalent type of venous involvement was deep vein thrombosis in the lower extremities. Thrombotic events in BD cannot be solely attributed to abnormalities in thrombotic factors. The treatment of thrombotic events in BD remains contentious, with anticoagulant efficacy being debated and immunosuppressive therapy representing the primary treatment approach. Behcet’s disease should be considered when a young male patient presents with an arterial or venous vascular event, especially if it is recurrent.

Vasküler Tutulumlu Behçet Hastalýðý; 147 Olgunun Deðerlendirilmesi ve Literatür Ýncelemesi

Amaç: Behçet Hastalýðý (BH) vücudun çeþitli organlarýný etkileyebilen sistemik vaskülit olup inflamasyonla seyreder. Diðer sistemik vaskülitlerde farklý olarak bu hastalýkta venöz aðýrlýklý tutulum sözkonusudur.
Çalýþma Planý: Merkezimizde Vasküler Behçet Hastalýðý tanýsý konulan 147 hastanýn demografik ve klinik özellikleri retrospektif olarak incelendi.
Bulgular: Vasküler Behçet Hastalýðý tanýsý alan hastalar, tüm Behçet hastalarýnýn %25'ini (147/589) oluþturmuþtur. Damar tutulumu ile cinsiyet arasýnda istatistiksel olarak anlamlý bir iliþki saptanmýþ olup aðýrlýklý olarak erkeklerde (%76.9) görülmüþtür. 71 hastada Behçet Hastalýðý izleminde vasküler olay geliþti ve 76 hastada (%51.70) vasküler olay sonrasý hastalýk tanýsý koyuldu. En sýk görülen vasküler olay alt ekstremitede derin ven trombozu (%69.4) idi. Arter tutulumu en çok pulmoner arterlerde görüldü (%12.90). Alt ekstremite derin ven trombozu genç hastalarda, pulmoner arter tutulumu ise daha yaþlý hastalarda saptandý. Genel olarak venler, arterlerden 4,5 kat daha fazla etkilenmiþtir.
Sonuç: Derin ven trombozu en sýk alt ekstremitede görülür ve bu hastalýkta trombotik olaylar trombotik faktörlerdeki anormallikler ile açýklanamaz. Behçet Hastalýðýnda trombotik olaylarýn tedavisinde antikoagülan tedavinin etkinliði net deðildir ve temel tedavi immünosupresif tedavidir. Genç erkek hastalar arteriyel veya vasküler bir olay ile baþvurduðunda ve özellikle tekrarlayan bir vasküler olay olduðunda, Behçet Hastalýðý düþünülmelidir. (SETB-2023-07-112)