Skip to main content
Erschienen in: Clinical Rheumatology 2/2008

01.02.2008 | Original Article

Treatment of venous thrombosis associated with Behcet’s disease: immunosuppressive therapy alone versus immunosuppressive therapy plus anticoagulation

verfasst von: Joong Kyong Ahn, You Sun Lee, Chan Hong Jeon, Eun-Mi Koh, Hoon-Suk Cha

Erschienen in: Clinical Rheumatology | Ausgabe 2/2008

Einloggen, um Zugang zu erhalten

Abstract

The aim of this study was to compare the efficacy of immunosuppressive therapy alone with that of combination therapy involving immunosuppressants and anticoagulation for the treatment of venous thrombosis in Behcet’s disease (BD). A retrospective analysis was made of 37 patients with venous thrombosis in BD. BD patients with venous thrombosis were divided into three groups: one group (N = 16) received immunosuppressive therapy alone, another group (N = 17) received immunosuppressant and anticoagulation combination therapy, and the third group (N = 4) received anticoagulation therapy only. Clinical and laboratory parameters and the recurrence of venous thrombosis were assessed. Venous thrombosis in BD appeared to have a more diffuse pattern than idiopathic type and a predilection for lower limbs. The most commonly involved sites were the superficial and common femoral veins. Recurrence of venous thrombosis occurred in two cases in the immunosuppressant group (12.5%), one case in the combination therapy group (5.9%), and three cases in the anticoagulant group (75%). No significant difference was found between recurrence in the immunosuppressant and combination therapy groups. Acute phase reactants were elevated in all six patients at the time of venous thrombosis recurrence. Our study suggests that immunosuppressive therapy is essential and that anticoagulation therapy might not be required for the treatment of deep venous thrombosis associated with BD.
Literatur
1.
Zurück zum Zitat Sakane T, Takeno M, Suzuki N, Inaba G (1999) Behcet’s disease. N Engl J Med 341:1284–1291PubMedCrossRef Sakane T, Takeno M, Suzuki N, Inaba G (1999) Behcet’s disease. N Engl J Med 341:1284–1291PubMedCrossRef
2.
Zurück zum Zitat Gurler A, Boyvat A, Tursen U (1997) Clinical manifestations of Behcet’s disease: an analysis of 2147 patients. Yonsei Med J 38:423–427PubMed Gurler A, Boyvat A, Tursen U (1997) Clinical manifestations of Behcet’s disease: an analysis of 2147 patients. Yonsei Med J 38:423–427PubMed
3.
Zurück zum Zitat Zouboulis CC, Kotter I, Djawari D, Kirch W, Kohl PK, Ochsendorf FR, Keitel W, Stadler R, Wollina U, Proksch E, Sohnchen R, Weber H, Gollnick HP, Holzle E, Fritz K, Licht T, Orfanos CE (1997) Epidemiological features of Adamantiades-Behcet’s disease in Germany and in Europe. Yonsei Med J 38:411–422PubMed Zouboulis CC, Kotter I, Djawari D, Kirch W, Kohl PK, Ochsendorf FR, Keitel W, Stadler R, Wollina U, Proksch E, Sohnchen R, Weber H, Gollnick HP, Holzle E, Fritz K, Licht T, Orfanos CE (1997) Epidemiological features of Adamantiades-Behcet’s disease in Germany and in Europe. Yonsei Med J 38:411–422PubMed
4.
Zurück zum Zitat Sarica-Kucukoglu R, Akdag-Kose A, Kayabal IM, Yazganoglu KD, Disci R, Erzengin D, Azizlerli G (2006) Vascular involvement in Behcet’s disease: a retrospective analysis of 2319 cases. Int J Dermatol 45:919–921PubMedCrossRef Sarica-Kucukoglu R, Akdag-Kose A, Kayabal IM, Yazganoglu KD, Disci R, Erzengin D, Azizlerli G (2006) Vascular involvement in Behcet’s disease: a retrospective analysis of 2319 cases. Int J Dermatol 45:919–921PubMedCrossRef
5.
Zurück zum Zitat Kural-Seyahi E, Fresko I, Seyahi N, Ozyazgan Y, Mat C, Hamuryudan V, Yurdakul S, Yazici H (2003) The long-term mortality and morbidity of Behcet syndrome: a 2-decade outcome survey of 387 patients followed at a dedicated center. Medicine (Baltimore) 82:60–76CrossRef Kural-Seyahi E, Fresko I, Seyahi N, Ozyazgan Y, Mat C, Hamuryudan V, Yurdakul S, Yazici H (2003) The long-term mortality and morbidity of Behcet syndrome: a 2-decade outcome survey of 387 patients followed at a dedicated center. Medicine (Baltimore) 82:60–76CrossRef
6.
Zurück zum Zitat Koc Y, Gullu I, Akpek G, Akpolat T, Kansu E, Kiraz S, Batman F, Kansu T, Balkanci F, Akkaya S et al (1992) Vascular involvement in Behcet’s disease. J Rheumatol 19:402–410PubMed Koc Y, Gullu I, Akpek G, Akpolat T, Kansu E, Kiraz S, Batman F, Kansu T, Balkanci F, Akkaya S et al (1992) Vascular involvement in Behcet’s disease. J Rheumatol 19:402–410PubMed
7.
Zurück zum Zitat Houman MH, Ben Ghorbel I, Khiari Ben Salah I, Lamloum M, Ben Ahmed M, Miled M (2001) Deep vein thrombosis in Behcet’s disease. Clin Exp Rheumatol 19:S48–S50PubMed Houman MH, Ben Ghorbel I, Khiari Ben Salah I, Lamloum M, Ben Ahmed M, Miled M (2001) Deep vein thrombosis in Behcet’s disease. Clin Exp Rheumatol 19:S48–S50PubMed
8.
Zurück zum Zitat Kabbaj N, Benjelloun G, Gueddari FZ, Dafiri R, Imani F (1993) [Vascular involvements in Behcet disease. Based on 40 patient records]. J Radiol 74:649–656PubMed Kabbaj N, Benjelloun G, Gueddari FZ, Dafiri R, Imani F (1993) [Vascular involvements in Behcet disease. Based on 40 patient records]. J Radiol 74:649–656PubMed
9.
Zurück zum Zitat Calamia KT, Schirmer M, Melikoglu M (2005) Major vessel involvement in Behcet disease. Curr Opin Rheumatol 17:1–8PubMedCrossRef Calamia KT, Schirmer M, Melikoglu M (2005) Major vessel involvement in Behcet disease. Curr Opin Rheumatol 17:1–8PubMedCrossRef
10.
Zurück zum Zitat Radke PW, Schwarz ER, Groesdonk H, Graf J, Janssens U (2001) Thrombosis in Behcet’s disease: report of a case followed by a systematic review using the methodology of evidence-based medicine. J Thromb Thrombolysis 11:137–141PubMedCrossRef Radke PW, Schwarz ER, Groesdonk H, Graf J, Janssens U (2001) Thrombosis in Behcet’s disease: report of a case followed by a systematic review using the methodology of evidence-based medicine. J Thromb Thrombolysis 11:137–141PubMedCrossRef
11.
Zurück zum Zitat Anonymous (1990) Criteria for diagnosis of Behcet’s disease. International Study Group for Behcet’s Disease. Lancet 335:1078–1080 Anonymous (1990) Criteria for diagnosis of Behcet’s disease. International Study Group for Behcet’s Disease. Lancet 335:1078–1080
12.
Zurück zum Zitat Espinosa G, Font J, Tassies D, Vidaller A, Deulofeu R, Lopez-Soto A, Cervera R, Ordinas A, Ingelmo M, Reverter JC (2002) Vascular involvement in Behcet’s disease: relation with thrombophilic factors, coagulation activation, and thrombomodulin. Am J Med 112:37–43PubMedCrossRef Espinosa G, Font J, Tassies D, Vidaller A, Deulofeu R, Lopez-Soto A, Cervera R, Ordinas A, Ingelmo M, Reverter JC (2002) Vascular involvement in Behcet’s disease: relation with thrombophilic factors, coagulation activation, and thrombomodulin. Am J Med 112:37–43PubMedCrossRef
13.
Zurück zum Zitat Probst K, Fijnheer R, Rothova A (2004) Endothelial cell activation and hypercoagulability in ocular Behcet’s disease. Am J Ophthalmol 137:850–857PubMedCrossRef Probst K, Fijnheer R, Rothova A (2004) Endothelial cell activation and hypercoagulability in ocular Behcet’s disease. Am J Ophthalmol 137:850–857PubMedCrossRef
14.
Zurück zum Zitat Leiba M, Seligsohn U, Sidi Y, Harats D, Sela BA, Griffin JH, Livneh A, Rosenberg N, Gelernter I, Gur H, Ehrenfeld M (2004) Thrombophilic factors are not the leading cause of thrombosis in Behcet’s disease. Ann Rheum Dis 63:1445–1449PubMedCrossRef Leiba M, Seligsohn U, Sidi Y, Harats D, Sela BA, Griffin JH, Livneh A, Rosenberg N, Gelernter I, Gur H, Ehrenfeld M (2004) Thrombophilic factors are not the leading cause of thrombosis in Behcet’s disease. Ann Rheum Dis 63:1445–1449PubMedCrossRef
15.
Zurück zum Zitat Gurgey A, Balta G, Boyvat A (2003) Factor V Leiden mutation and PAI-1 gene 4G/5G genotype in thrombotic patients with Behcet’s disease. Blood Coagul Fibrinolysis 14:121–124PubMedCrossRef Gurgey A, Balta G, Boyvat A (2003) Factor V Leiden mutation and PAI-1 gene 4G/5G genotype in thrombotic patients with Behcet’s disease. Blood Coagul Fibrinolysis 14:121–124PubMedCrossRef
16.
Zurück zum Zitat Merkel PA, Lo GH, Holbrook JT, Tibbs AK, Allen NB, Davis JC Jr, Hoffman GS, McCune WJ, St Clair EW, Specks U, Spiera R, Petri M, Stone JH (2005) Brief communication: high incidence of venous thrombotic events among patients with Wegener granulomatosis: the Wegener’s Clinical Occurrence of Thrombosis (WeCLOT) Study. Ann Intern Med 142:620–626PubMed Merkel PA, Lo GH, Holbrook JT, Tibbs AK, Allen NB, Davis JC Jr, Hoffman GS, McCune WJ, St Clair EW, Specks U, Spiera R, Petri M, Stone JH (2005) Brief communication: high incidence of venous thrombotic events among patients with Wegener granulomatosis: the Wegener’s Clinical Occurrence of Thrombosis (WeCLOT) Study. Ann Intern Med 142:620–626PubMed
18.
Zurück zum Zitat Duzgun N, Ates A, Aydintug OT, Demir O, Olmez U (2006) Characteristics of vascular involvement in Behcet’s disease. Scand J Rheumatol 35:65–68PubMedCrossRef Duzgun N, Ates A, Aydintug OT, Demir O, Olmez U (2006) Characteristics of vascular involvement in Behcet’s disease. Scand J Rheumatol 35:65–68PubMedCrossRef
19.
Zurück zum Zitat Mader R, Ziv M, Adawi M, Mader R, Lavi I (1999) Thrombophilic factors and their relation to thromboembolic and other clinical manifestations in Behcet’s disease. J Rheumatol 26:2404–2408PubMed Mader R, Ziv M, Adawi M, Mader R, Lavi I (1999) Thrombophilic factors and their relation to thromboembolic and other clinical manifestations in Behcet’s disease. J Rheumatol 26:2404–2408PubMed
20.
Zurück zum Zitat Silingardi M, Salvarani C, Boiardi L, Accardo P, Iorio A, Olivieri I, Cantini F, Salvi F, La Corte R, Triolo G, Ciccia F, Ghirarduzzi A, Filippini D, Paolazzi G, Iori I (2004) Factor V Leiden and prothrombin gene G20210A mutations in Italian patients with Behcet’s disease and deep vein thrombosis. Arthritis Rheum 51:177–183PubMedCrossRef Silingardi M, Salvarani C, Boiardi L, Accardo P, Iorio A, Olivieri I, Cantini F, Salvi F, La Corte R, Triolo G, Ciccia F, Ghirarduzzi A, Filippini D, Paolazzi G, Iori I (2004) Factor V Leiden and prothrombin gene G20210A mutations in Italian patients with Behcet’s disease and deep vein thrombosis. Arthritis Rheum 51:177–183PubMedCrossRef
21.
Zurück zum Zitat Hooten WM, O’Duffy JD (1998) 29-year-old man with recurrent deep venous thrombosis and skin lesions. Mayo Clin Proc 73:463–466PubMedCrossRef Hooten WM, O’Duffy JD (1998) 29-year-old man with recurrent deep venous thrombosis and skin lesions. Mayo Clin Proc 73:463–466PubMedCrossRef
Metadaten
Titel
Treatment of venous thrombosis associated with Behcet’s disease: immunosuppressive therapy alone versus immunosuppressive therapy plus anticoagulation
verfasst von
Joong Kyong Ahn
You Sun Lee
Chan Hong Jeon
Eun-Mi Koh
Hoon-Suk Cha
Publikationsdatum
01.02.2008
Verlag
Springer-Verlag
Erschienen in
Clinical Rheumatology / Ausgabe 2/2008
Print ISSN: 0770-3198
Elektronische ISSN: 1434-9949
DOI
https://doi.org/10.1007/s10067-007-0685-z

Weitere Artikel der Ausgabe 2/2008

Clinical Rheumatology 2/2008 Zur Ausgabe

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.