Related Experiment Videos
Massive thrombosis after central venous catheterization in a patient with previously undiagnosed Behcet's disease
1Department of Anesthesiology, Research Institute of Clinical Medicine, Chonbuk National University Medical, School & Hospital, Chonju, Korea.
Insights
Central venous catheterization can cause thrombosis, especially in patients with Behcet's disease (BD). Early diagnosis and steroid therapy are crucial for managing recurrent thrombosis in BD patients.
Area of Science:
- Vascular Medicine
- Rheumatology
- Internal Medicine
Background:
- Thrombosis is a significant complication of central venous catheterization.
- Patient's underlying medical conditions can influence thrombogenesis.
- Behcet's disease (BD) is a multisystem vasculitis often challenging to diagnose.
Observation:
- A 24-year-old female developed massive central venous thrombosis and superior vena cava syndrome post-subclavian vein catheterization.
- Recurrent thrombosis occurred despite thrombectomy and anticoagulation.
- Diagnosis of Behcet's disease was established after recurrent thrombosis.
Findings:
- Behcet's disease is a potential risk factor for central venous thrombosis.
- Steroid therapy effectively managed recurrent thrombosis in this BD patient.
- Central venous catheterization in BD patients requires heightened caution.
Implications:
- Highlights the importance of considering Behcet's disease in patients with unexplained central venous thrombosis.
- Suggests a potential role for early immunosuppressive therapy in preventing catheter-related thrombosis in BD.
- Underscores the need for careful patient selection and monitoring during central venous catheterization in individuals with vasculitic conditions.
Abstract:
Thrombosis is an important complication of central venous catheterization. Among the many intrinsic and extrinsic factors, the patient's medical disease can play a role in thrombogenesis. Behcet's disease (BD), classified as a vasculitis, is a multisystem disease involving the small blood vessels. It is often difficult to recognize and diagnose the disease. A 24-yr-old female patient showed massive central venous thrombosis which caused superior vena cava syndrome after subclavian vein catheterization. Twenty days after catheterization, the patient exhibited swelling of the face, neck, and both upper extremities. Despite thrombectomy and continuous anticoagulation therapy, her facial and upper extremity swelling reappeared and follow-up chest computed tomography (CT) showed the recurrent thrombosis in the same central veins previously affected. A diagnosis of BD was then made. Following steroid therapy, neither clinical symptoms nor CT findings suggestive of central venous thrombosis were observed during the subsequent 6-months of follow-up period. This case emphasizes that central venous catheterization in a patient with BD should be performed with great caution.