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Arterial thrombosis leading to intestinal infarction in a patient with Behçet's disease associated with protein C
Y Bayraktar1, A R Soylu, F Balkanci
1Department of Gastroenterology, Hacettepe University, School of Medicine, Ankara, Turkey.
Insights
Behçet
Area of Science:
- Vascular Medicine
- Gastroenterology
- Rheumatology
Background:
- Behçet's disease is a rare multisystem inflammatory disorder.
- It can manifest with vascular complications, including arterial and venous thrombosis.
- Intestinal infarction is a severe, though uncommon, manifestation.
Observation:
- A 41-year-old male with a 15-year history of Behçet's disease presented with severe abdominal pain and bloody diarrhea.
- He had a prior diagnosis of superior mesenteric artery thrombosis leading to intestinal infarction.
- Recurrent symptoms led to the discovery of an infrarenal abdominal aorta thrombus.
Findings:
- This case highlights Behçet's disease complicated by recurrent mesenteric artery thrombosis and abdominal aorta thrombosis.
- Protein C deficiency was identified as a potential secondary factor contributing to the thrombotic events.
- This represents the first reported instance of combined mesenteric artery and abdominal aorta thrombosis associated with Behçet's disease and protein C deficiency.
Implications:
- This case underscores the critical need for vigilant monitoring of vascular complications in Behçet's disease patients.
- It suggests that coexisting thrombophilias, such as protein C deficiency, may increase the risk of severe vascular events.
- Further research into the interplay between Behçet's disease, vasculitis, and thrombophilia is warranted.
Abstract:
Behçet's disease may be a possible cause of both occlusive and aneurysmal arterial involvement as well as recurrent venous thrombosis. A case of Behçet's disease complicated with vascular involvement leading to intestinal infarction is presented. A 41-yr-old man suffering from Behçet's disease for 15 yr presented with a 2-day history of severe abdominal pain and bloody diarrhea. Intestinal infarction secondary to thrombosis of the superior mesenteric artery had been diagnosed during surgical exploration 3 yr previously. He was started on anticoagulation with nutritional support. The patient was readmitted with severe diarrhea and malabsorption symptoms 3 yr after intestinal resection. A thrombus located in the posterior wall of the infrarenal portion of aorta was detected by aortography and ultrasonography. Although thrombosis is a relatively common complication of Behçet's disease caused by vasculitis, protein C deficiency, which is a pertinent laboratory finding in this case, might be a secondary factor in the thrombotic event. This is the first case reported of mesenteric artery thrombosis leading to bowel infarction and abdominal aorta thrombosis associated with protein C deficiency.