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Pattern and outcome of vascular involvement of Omani patients with Behcet's disease
1Department of Medicine, Rheumatology Unit, Sultan Qaboos University Hospital, Muscat, Sultanate of Oman. jkalkaabi@hotmail.com
Insights
Vascular events in Behcet's disease (BD) affect 23% of Omani patients, particularly younger males with shorter disease duration. Immunosuppressive therapy successfully treated pulmonary artery aneurysms and intracardiac thrombi.
Area of Science:
- Rheumatology
- Vascular Medicine
- Internal Medicine
Background:
- Behcet's disease (BD) is a multisystem inflammatory disorder with a significant risk of vascular complications.
- Understanding the pattern and outcomes of vascular events in specific populations, like Omani patients, is crucial for effective management.
Purpose of the Study:
- To investigate the pattern, frequency, and outcomes of vascular events in Omani patients diagnosed with Behcet's disease.
- To identify risk factors associated with the development of thrombosis in this cohort.
Main Methods:
- A retrospective study involving 40 Omani patients with Behcet's disease.
- Clinical data collection included demographics, disease duration, activity (ESR, CRP), and vascular manifestations.
- Vascular events were assessed using imaging techniques such as Doppler ultrasonography, angiography, MRI, CT, and echocardiography.
Main Results:
- Nine patients (23%) experienced vascular events, with a mean age of 24 years and disease duration of 3.8 years at onset.
- Vascular involvement included venous lesions (22%), arterial lesions (33%), and mixed lesions (44%).
- Two patients presented with pulmonary artery aneurysm (PAA) and intracardiac thrombus, which resolved with immunosuppressive therapy.
Conclusions:
- The frequency of vascular complications in Omani BD patients aligns with global reports.
- Younger males with shorter disease duration are at higher risk for thrombosis.
- Immunosuppressive therapy demonstrated efficacy in treating pulmonary artery aneurysms and intracardiac thrombi without anticoagulation.
Abstract:
The objective of the study is to study the pattern, frequency and outcome of vascular events in Omani patients with Behcet's disease (BD). Forty BD patients were recruited. Clinical data parameters were recorded, including age at onset, disease duration, current disease activity, and the vascular manifestations of the disease (current and past events). Disease activity was assessed by ESR, CRP and also clinically. For venous and arterial thrombotic events, imaging studies, such as Doppler ultrasonography, angiography, MRI, CT, and echocardiography were performed. Nine patients had vascular events (23%). The mean age of these patients at diagnosis of the vascular event was 24 years (range 15-37) and the mean disease duration at onset of the vascular event was 3.8 years (range 3-5); this was significant when compared with patients without thrombosis (P=0.001, Mann-Whitney test). In these patients with vascular involvement, two patients (22%) had venous lesions, three (33%) patients had arterial lesions and four patients (44%) had mixed lesions. Two patients (22%) had pulmonary artery aneurysm (PAA) and concomitant intracardiac thrombus, and further one patient also had PAA. Immunosuppressive therapy resulted in the resolution of PAA and intracardiac thrombous. In conclusion, the frequency of vascular complications of BD in our patients is similar to those reported around the world. We found younger male patients with short disease duration are at a greater risk of developing thrombosis. Medical treatment with immunosuppressive therapy without anticoagulation seems successful in treating PAA and intracardiac thrombus.
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