Clinical presentation and treatment outcomes of arterial involvement in Behçet’s disease: a single-centre experience
Abstract Arterial involvement, although rare, accounts for significant mortality and morbidity in patients of Behçet’s disease (BD). There is paucity of data on arterial BD. The objective of this 5-year retrospective cohort study was to examine the clinical presentation, pattern of arterial involvement, and treatment outcome in Indian arterial BD patients. Data on demography, clinical presentation, radiology, instituted therapy, vascular interventions and treatment outcomes were recorded and analyzed. Ten (16.9%) out of 59 patients with BD had arterial involvement in 13 vascular territories [mean age 30 (8) years, 9 (90%) males]. Pulmonary artery was most commonly involved (46%), followed by abdominal aorta (15%), femoral artery (15%), descending thoracic aorta (8%), common iliac (8%), and dorsalis pedis artery (8%). Two patients had multi-territory involvement. The median interval between disease onset and development of arterial aneurysms was 3 years (3 months–12 years). Concomitant deep vein thrombosis was seen in 60% cases. Prednisolone and cyclophosphamide were the most common immunosuppressive therapy used; one patient who relapsed on cyclophosphamide responded to infliximab. Five surgical or endovascular interventions were performed. Four patients (40%) died due to aneurysm rupture—all had a delayed diagnosis, and three had pulmonary artery involvement, with death due to massive hemoptysis. Based on the present study, we concluded that arterial involvement in BD is seen predominantly in males and has a high mortality. Early detection and aggressive treatment with immunosuppression and surgical or endovascular interventions are essential for good outcomes..
| Medienart: |
Artikel |
|---|
| Erscheinungsjahr: |
2021 |
|---|---|
| Erschienen: |
2021 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:42 |
|---|---|
| Enthalten in: |
Rheumatology international - 42(2021), 1 vom: 18. Okt., Seite 115-120 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Chattopadhyay, Arghya [VerfasserIn] |
|---|
| Links: |
Volltext [lizenzpflichtig] |
|---|
| Themen: |
|---|
| Anmerkungen: |
© The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature 2021 |
|---|
| doi: |
10.1007/s00296-021-05022-y |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
OLC2077788526 |
|---|
| LEADER | 01000caa a22002652 4500 | ||
|---|---|---|---|
| 001 | OLC2077788526 | ||
| 003 | DE-627 | ||
| 005 | 20230507083842.0 | ||
| 007 | tu | ||
| 008 | 221220s2021 xx ||||| 00| ||eng c | ||
| 024 | 7 | |a 10.1007/s00296-021-05022-y |2 doi | |
| 035 | |a (DE-627)OLC2077788526 | ||
| 035 | |a (DE-He213)s00296-021-05022-y-p | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 082 | 0 | 4 | |a 610 |q VZ |
| 100 | 1 | |a Chattopadhyay, Arghya |e verfasserin |0 (orcid)0000-0003-3917-1977 |4 aut | |
| 245 | 1 | 0 | |a Clinical presentation and treatment outcomes of arterial involvement in Behçet’s disease: a single-centre experience |
| 264 | 1 | |c 2021 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ohne Hilfsmittel zu benutzen |b n |2 rdamedia | ||
| 338 | |a Band |b nc |2 rdacarrier | ||
| 500 | |a © The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature 2021 | ||
| 520 | |a Abstract Arterial involvement, although rare, accounts for significant mortality and morbidity in patients of Behçet’s disease (BD). There is paucity of data on arterial BD. The objective of this 5-year retrospective cohort study was to examine the clinical presentation, pattern of arterial involvement, and treatment outcome in Indian arterial BD patients. Data on demography, clinical presentation, radiology, instituted therapy, vascular interventions and treatment outcomes were recorded and analyzed. Ten (16.9%) out of 59 patients with BD had arterial involvement in 13 vascular territories [mean age 30 (8) years, 9 (90%) males]. Pulmonary artery was most commonly involved (46%), followed by abdominal aorta (15%), femoral artery (15%), descending thoracic aorta (8%), common iliac (8%), and dorsalis pedis artery (8%). Two patients had multi-territory involvement. The median interval between disease onset and development of arterial aneurysms was 3 years (3 months–12 years). Concomitant deep vein thrombosis was seen in 60% cases. Prednisolone and cyclophosphamide were the most common immunosuppressive therapy used; one patient who relapsed on cyclophosphamide responded to infliximab. Five surgical or endovascular interventions were performed. Four patients (40%) died due to aneurysm rupture—all had a delayed diagnosis, and three had pulmonary artery involvement, with death due to massive hemoptysis. Based on the present study, we concluded that arterial involvement in BD is seen predominantly in males and has a high mortality. Early detection and aggressive treatment with immunosuppression and surgical or endovascular interventions are essential for good outcomes. | ||
| 650 | 4 | |a Behçet syndrome | |
| 650 | 4 | |a Vasculitis | |
| 650 | 4 | |a Arterial involvement | |
| 650 | 4 | |a Angio-Behçet | |
| 700 | 1 | |a Jain, Siddharth |0 (orcid)0000-0003-4065-5880 |4 aut | |
| 700 | 1 | |a Naidu, G. S. R. S. N. K. |0 (orcid)0000-0002-9727-044X |4 aut | |
| 700 | 1 | |a Dhir, Varun |0 (orcid)0000-0002-3626-0694 |4 aut | |
| 700 | 1 | |a Chhabria, Bharath |0 (orcid)0000-0002-1002-3690 |4 aut | |
| 700 | 1 | |a Acharya, Nupoor |0 (orcid)0000-0002-2651-0864 |4 aut | |
| 700 | 1 | |a Muthu, Valliappan |0 (orcid)0000-0003-0410-8468 |4 aut | |
| 700 | 1 | |a Singhal, Manphool |0 (orcid)0000-0002-1311-7203 |4 aut | |
| 700 | 1 | |a Savlania, Ajay |0 (orcid)0000-0001-7801-0012 |4 aut | |
| 700 | 1 | |a Vijayvergiya, Rajesh |0 (orcid)0000-0001-5250-4735 |4 aut | |
| 700 | 1 | |a Jain, Sanjay |0 (orcid)0000-0002-0141-7655 |4 aut | |
| 700 | 1 | |a Sharma, Aman |0 (orcid)0000-0003-0813-1243 |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Rheumatology international |d Springer Berlin Heidelberg, 1981 |g 42(2021), 1 vom: 18. Okt., Seite 115-120 |w (DE-627)129098183 |w (DE-600)8286-7 |w (DE-576)014434903 |x 0172-8172 |7 nnns |
| 773 | 1 | 8 | |g volume:42 |g year:2021 |g number:1 |g day:18 |g month:10 |g pages:115-120 |
| 856 | 4 | 1 | |u https://doi.org/10.1007/s00296-021-05022-y |z lizenzpflichtig |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a SYSFLAG_A | ||
| 912 | |a GBV_OLC | ||
| 912 | |a SSG-OLC-PHA | ||
| 912 | |a SSG-OLC-DE-84 | ||
| 951 | |a AR | ||
| 952 | |d 42 |j 2021 |e 1 |b 18 |c 10 |h 115-120 | ||