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Venous claudication in Behçet's disease
Serdal Ugurlu1, Emire Seyahi1, Veysel Oktay2
1Division of Rheumatology, Department of Medicine, Cerrahpaşa Medical Faculty, University of Istanbul, Istanbul, Turkey.
Insights
Venous claudication is a frequent symptom in Behçet's disease (BD) patients with lower extremity venous thrombosis (LEVT), affecting up to one third. This condition impairs walking capacity in about 10% of these individuals.
Area of Science:
- Vascular Medicine
- Rheumatology
- Nephrology
Background:
- Venous claudication is notably more prevalent in Behçet's disease (BD) patients.
- Previous research suggested a link between venous claudication and lower extremity venous thrombosis (LEVT) in men with BD.
Purpose of the Study:
- To prospectively reassess the occurrence of venous claudication in BD patients.
- To evaluate the impact of LEVT on the prevalence and severity of venous claudication.
Main Methods:
- A prospective study involving 61 BD patients with LEVT, 40 BD patients without vascular involvement, and 56 healthy controls.
- Assessment of venous claudication using a standardized questionnaire and a 10-minute treadmill exercise test.
- Measurement of ankle-brachial pressure indices to rule out peripheral arterial disease.
Main Results:
- 34% of BD patients with LEVT reported venous claudication via questionnaire, compared to 5% of BD patients without vascular involvement and 0% of controls (P < .001).
- During treadmill exercise, 21% of BD patients with LEVT experienced claudication symptoms, versus 8% of BD patients without vascular disease and 2% of controls (P = .002).
- Six (10%) BD patients with LEVT had to discontinue the treadmill test due to claudication.
Conclusions:
- Venous claudication is a significant and common complication in BD patients with LEVT, affecting up to one-third of this population.
- The symptom can substantially impair walking capacity in approximately 10% of affected BD patients with LEVT.
Objective:
We have previously shown that venous claudication is significantly more common among patients with Behçet's disease (BD) and had proposed that this was a "venous claudication" because it was specifically more common among men with lower extremity venous thrombosis (LEVT). With this study, we reassessed the presence of claudication prospectively by a questionnaire and a treadmill exercise.
Methods:
We studied all men: 61 BD patients with LEVT, 40 BD patients without vascular involvement, and 56 healthy controls. Venous claudication was assessed by a standardized questionnaire. In addition, patients were asked to walk on a treadmill for 10 minutes. Patients who experienced symptoms consistent with venous claudication but still able to walk and those who had to give up the treadmill exercise were noted. Ankle-brachial pressure indices measured before and after the treadmill test did not indicate any peripheral arterial disease.
Results:
Twenty-one BD patients with LEVT (34%), two BD patients without vascular involvement (5%), and none of the healthy controls described venous claudication when assessed with the questionnaire (P < .001). There were significantly more patients who described claudication during the treadmill exercise among patients with LEVT (21%) compared with those with no vascular disease (8%) and healthy controls (2%) (P = .002). Finally, only those with LEVT (6 of 61) had to stop the treadmill challenge because of claudication.
Conclusions:
Venous claudication is a severe and frequent symptom, being present in up to one third of BD patients with LEVT. It impairs walking capacity in 10% of these patients.
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