Arthritis & Rheumatism, Volume 63,
November 2011 Abstract Supplement
Abstracts of the American College of
Rheumatology/Association of Rheumatology Health Professionals
Annual Scientific Meeting
Chicago, Illinois November 4-9, 2011.
Major Arterial Involvement in Behet's Disease: Results From a Single Centre about 29 Cases.
Mezalek, Z. Tazi, Ammouri, W., Harmouche, H., Maamar, M., Bourkia, M., Adnaoui, M., Aouni, M.
Behçet's disease is a multisystem pathology, and survival is closely related to vascular involvement. We analyse the clinical findings, treatment, outcome, and prevalence of arterial disease in a cohort of patients with BD from single tertiary referral medical center.
Medical records of consecutive patients with arterial involvement were reviewed to determine the clinical characteristics of BD, the sites, laboratory test results, and response to treatment. The diagnosis of BD was made according to the international criteria of BD. Statistical analysis was performed to define factors that affect prognosis.
Among a cohort of 292 patients with BD, arterial involvement was present in 29 patients (10%) The over age at diagnosis was 33.9+9.6 years, with a large predominance of males (25 cases). In 16 patients (55%), arterial involvement leads to the BD diagnosis. In the other cases, patients presented with ocular symptoms in 13, venous thrombosis in 10 and fever in 1 case. Arterial involvement was present at the initial presentation of the disease. Symptomatic lesions presented in 15 patients (55%), and asymptomatic lesions were incidentally detected in 13 (45%). There were 28 aneurysms and pseudo aneurysms: 14 in pulmonary territory, 4 infrarenal abdominal aorta, 3 cases of each superficial femoral and carotid arteries, 2 subclavian and one of each thoracic aorta and coronary artery. Were reported 2 cases of stenosis: one of the abdominal aorta and of coronary artery. Compared with BD patients without arterial involvement, those with arterial disease had higher rate of venous thrombosis (p=0.02), of ocular disease (p=0.03), were mostly man (p= 0.003) and had higher rate of biological inflammation (p=0.004). All patients were treated with corticosteroids, and 25 received immunosuppressive therapy. Surgical treatment was possible in 8 patients. For pulmonary aneurysm, an embolisation was made in 3 cases. Four patients died from pulmonary aneurysms. Recurrence was observed in 4 patients (14%) after treatment with stent graft (n = 1), as venous thrombosis in 2 case and as a new pulmonary aneurysm in one. The other cases remain stables.
The rate of arterial involvement is high in our series, probably in relation with the recruitment of a tertiary referral center. Therefore, we suggest that routine examination of symptoms and signs of arterial disease is necessary in male BD patients with venous thrombosis and/or ocular disease and/or inflammatory syndrome.
To cite this abstract, please use the following information:
Mezalek, Z. Tazi, Ammouri, W., Harmouche, H., Maamar, M., Bourkia, M., Adnaoui, M., et al; Major Arterial Involvement in Behet's Disease: Results From a Single Centre about 29 Cases. [abstract]. Arthritis Rheum 2011;63 Suppl 10 :1040