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[A case of Behçet disease with transverse sinus thrombosis and successful treatment with colchicine]
S Hayashi1, Y Sakashita, Y Ide
1Department of Neurology, Kanazawa University School of Medicine.
Insights
Behçet disease can cause cerebral sinus thrombosis, a serious condition. Magnetic resonance imaging (MRI) and colchicine treatment effectively managed sinus thrombosis in this patient.
Area of Science:
- Neurology
- Rheumatology
- Radiology
Background:
- Behçet disease is a rare multisystem inflammatory disorder.
- Cerebral sinus thrombosis is a rare but serious complication of Behçet disease.
Observation:
- A 64-year-old male with a history of Behçet disease presented with headache and fever.
- Initial symptoms included psychiatric disturbances attributed to enoxacin, which resolved upon discontinuation.
- Brain MRI and angiography confirmed right transverse sinus thrombosis.
Findings:
- Magnetic resonance imaging (MRI) and cerebral angiography were crucial in diagnosing right transverse sinus thrombosis.
- Treatment with colchicine, isosorbide, and ticlopidine led to a reduction in sinus thrombosis size.
- Corticosteroids were contraindicated due to a gastric ulcer.
Implications:
- This case highlights the utility of MRI in diagnosing cerebral sinus thrombosis in Behçet disease patients.
- Colchicine demonstrates efficacy in managing sinus thrombosis associated with Behçet disease.
- Early diagnosis and appropriate management are vital for favorable clinical outcomes in complicated Behçet disease.
Abstract:
A 64-year-old man was admitted to our hospital because of headache and fever. Four months before admission, he had suffered from thrombophlebitis of the legs, erythema, oral aphtha and genital ulcers, and was diagnosed as having Behçet disease. Several days prior to admission he developed fever and was treated with enoxacine, which caused disorientation and abnormal behavior. These psychiatric symptoms disappeared after enoxacine was discontinued. On admission he was neurologically normal. Fever and headache disappeared spontaneously. However, he complained again of headache, and was suspected to have cerebral sinus thrombosis. Brain CT scan showed no abnormality, but brain MRI and cerebral angiography demonstrated right transverse sinus thrombosis and stasis. He was treated with colchicine, isosorbide, and ticlopidine. Because he had a gastric ulcer, corticosteroids were not indicated. Two months later, brain MRI demonstrated reduction of the size of the sinus thrombosis, and the clinical outcome was favorable. We would like to emphasize the usefulness of MRI and colchicine in the patient with Behçet disease complicated by sinus thromboses.