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Colchicine therapy for deep vein thrombosis in a patient with vascular-type Behçet disease: A case report
Daishi Nonaka1, Hiroyuki Takase, Masashi Machii
1Department of Internal Medicine, Enshu Hospital, JA Shizuoka Kohseiren, 1-1-1 Chuo, Naka-ku, Hamamatsu, Shizuoka, Japan.
Insights
Behçet Disease (BD) can cause deep vein thrombosis (DVT) and pulmonary artery thrombosis (PAT). Colchicine effectively treated thrombosis in a BD patient, resolving symptoms and preventing recurrence.
Area of Science:
- Vascular Medicine
- Rheumatology
- Immunology
Background:
- Behçet Disease (BD) is a chronic inflammatory vasculitis characterized by thrombogenicity and multisystemic manifestations.
- Deep vein thrombosis (DVT) is the most common vascular complication in BD, yet BD is rarely identified as a cause of thrombosis.
- Limited reports exist on managing thrombosis in BD patients.
Observation:
- A 40-year-old Asian male presented with left leg pain, edema, and swelling, indicative of DVT.
- Contrast computed tomography angiogram confirmed DVT and pulmonary artery thrombosis (PAT).
- The patient also exhibited oral ulcerations and skin lesions, consistent with BD.
Findings:
- Initial treatment with anticoagulants showed inadequate improvement for DVT.
- Addition of colchicine, an anti-inflammatory agent, led to significant resolution of DVT and PAT.
- Anticoagulation was discontinued, with colchicine monotherapy maintaining remission for 6 months post-discharge.
Implications:
- This case highlights the importance of considering BD in the differential diagnosis of DVT, especially in patients with characteristic mucocutaneous lesions.
- Colchicine therapy demonstrates efficacy in managing inflammation-induced thrombosis associated with Behçet Disease.
- Further research into anti-inflammatory treatments for BD-related thrombosis is warranted.
Rationale:
Behçet Disease (BD) is a chronic inflammatory vasculitis with thrombogenicity and multisystem involvement. Deep vein thrombosis (DVT) in the lower extremities is the most frequent manifestation of vascular involvement in BD. The causes of thrombosis vary widely and include congenital predisposition and acquired factors, but of all the thrombosis, the cause is rarely BD. Furthermore, there are few reports of treatment for thrombosis in BD.
Patient Concerns:
We herein describe the case of an Asian male patient aged 40 years, admitted to our hospital for left leg pain, edema, and swelling.
Diagnoses:
We confirmed the DVT and pulmonary artery thrombosis (PAT) by contrast computed tomography angiogram. At the same time, the patient developed oral ulcerations and skin lesions consistent with BD.
Interventions:
The patient was initially treated with anticoagulants. However, because the improvement of DVT was inadequate, we added colchicine in anticipation of anti-inflammatory effects. After that, anticoagulation was discontinued, and only colchicine was continuously prescribed.
Outcomes:
We observed an almost complete resolution of DVT and PAT with no recurrence of thrombosis for 6 months after discharge.
Lessons:
This case shows us that we should consider BD as a differential diagnosis of DVT and that colchicine therapy is effective for inflammation-induced thrombosis in BD.
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