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Published on: April 29, 2013
Cardiac involvement of Behcet's disease in children: a single-center study from Turkey
Meryem Beyazal1, Cansu Çetin Şenturk2, Sultan Nilay Yoğun3
1Pediatric Cardiology Department, Children Hospital, Ankara Bilkent City Hospital, 1604 th Street, No: 9, 06800, Çankaya, Ankara, Turkey. drmeryemce@hotmail.com.
Insights
Cardiac involvement in Behçet's disease is rare in children, with valvulitis and intracardiac thrombus being most common. Younger age, elevated ESR and platelets, and erythema nodosum may indicate higher risk for thrombus.
Area of Science:
- Pediatric Rheumatology
- Pediatric Cardiology
- Internal Medicine
Background:
- Behçet's disease (BD) is a rare multisystemic inflammatory disorder.
- Cardiac involvement, though infrequent, can manifest as intracardiac thrombosis, valve insufficiency, and myocardial infarction.
Purpose of the Study:
- To characterize cardiac involvement in pediatric Behçet's disease.
- To identify predictors of cardiac complications, specifically intracardiac thrombus.
- To investigate the influence of sex on BD and its cardiac manifestations in children.
Main Methods:
- Retrospective descriptive analytical study of pediatric patients (<18 years) diagnosed with Behçet's disease.
- Data collected from electronic medical records, including clinical, laboratory, electrocardiographic, and echocardiographic findings.
- Ninety pediatric patients with Behçet's disease were analyzed.
Main Results:
- Cardiac involvement was detected in 14% (14/90) of patients, with valvulitis being the most frequent manifestation.
- Intracardiac thrombus occurred in 4.3% (4/90) of patients.
- Higher probability of intracardiac thrombus was associated with younger age, elevated erythrocyte sedimentation rate (ESR), and increased platelet (PLT) count.
- Erythema nodosum significantly increased the risk of intracardiac thrombus (OR 13).
Conclusions:
- Valvulitis and intracardiac thrombus are the primary cardiac manifestations of Behçet's disease in the pediatric population.
- Clinical and laboratory markers like younger age, elevated ESR and PLT, and presence of erythema nodosum are crucial for early detection of intracardiac thrombus.
- Sex did not demonstrate a significant impact on cardiac involvement in pediatric Behçet's disease.
Abstract:
Cardiac involvement such as intracardiac thrombosis, valve insufficiency, and myocardial infarction may, though rarely, develop in Behçet's disease. The purpose of this study was to evaluate the characteristics and predictors of cardiac involvement in Behçet's disease in children. It also aimed to investigate the effect of sex on Behçet's disease and cardiac involvement. This retrospective descriptive analytical study was conducted in patients under 18 years of age who were diagnosed with Behcet's disease. Clinical, laboratory, electrocardiographic and echocardiographic findings of the patients were obtained from electronic medical records. Ninety patients with Behçet's disease were included in the study. Of the patients, 50 (53.8%) were female and the median age at the diagnosis time was 15 (2-18) years. Cardiac involvement was observed in 14 of 90 Behçet's disease patients and valvulitis was the most common involvement. Intracardiac thrombus was detected in 4 (4.3%) patients: two in the right ventricle, one in the right atrium, and one in the left atrium. The probability of intracardiac thrombus was higher in younger patients and in those who had increased levels of erythrocyte sedimentation rate (ESR) and platelets (PLT) at the time of diagnosis. The risk of intracardiac thrombus development was 13 times higher in patients with erythema nodosum (95% CI = 1.32-127,7).Conclusions: The most common cardiac manifestations of Behçet's disease in children are valvulitis and intracardiac thrombus. Younger age, increased ESR and PLT, and the presence of erythema nodosum may alert the clinician to the possibility of intracardiac thrombus. Sex has not been shown to have an effect on cardiac involvement.
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