Endocarditis, Intra-cardiac Thrombus, and Pulmonary Artery Aneurysm in a Patient with Behcet's Syndrome
Year: 2024
Type: article
Study design: Case Report
Abstract: B ehcet's Syndrome (BS) is a chronic vasculitis of un- known etiology.[1] BS was described in 1937 by Dr. Hulusi Behcet.[2] Its major diagnostic criteria include relapsing oral and genital ulcers, ocular and skin lesions, and a positive pathergy test.The minor diagnostic criteria for BS include arthropathy, neurologic symptoms, and cardiovascular and gastrointestinal lesions.The condition is mainly characterized by vasculitis, nonspecific inflammation, necrosis, aneurysm, thrombosis, and vascular occlusion and may affect vessels of any type, location, and size.[3] The major vascular presentation of BS is venous thrombophlebitis, which is more often a poor prognostic marker and requires aggressive treatment.[4] Arterial involvement, though rare, can cause serious complications in the lungs, and it is also a poor prognostic marker.A rare coronary artery disease, as well as intracardiac thrombus, is usually associated with pulmonary artery involvement.[5] Pulmonary artery aneurysm (PAA), pulmonary thromboembolism (PTE), and Behçet's Syndrome (BS) is a chronic vasculitis of unknown etiology.Arterial involvement occurring in the pulmonary artery is associated with poor prognosis.It may cause pulmonary thrombus (PTE) and aneurysm (PAA) which may also lead to a rare complication, intracardiac thrombus.PAA and PTE can be complications of BS and are associated with high morbidity and mortality.A 30-year-old male patient had a fever of 38.4°C, recurrent oral-genital ulcers, shortness of breath, cough, and sputum.In this case report, medical history, clinical and laboratory examinations, radiography, echocardiography, and computer tomography imaging examinations were performed.PAA, PTE, intracardiac and left popliteal vein thrombosis, and infective endocarditis were present.The patient was diagnosed with BS according to the International Study Group criteria.Surgery was performed for intracardiac thrombus.Vegetation within the thrombus was demonstrated histopathologically.The patient's clinical condition and laboratory tests improved with intervention and medical treatments.The patient with BS, PAA, PTE, intracardiac thrombus, and infective endocarditis was successfully treated with pulmonary embolization, antibiotics, and systemic immunosuppression, despite its rarity, poor prognosis, and high morbidity and mortality rates.
Author: Fatih Yildiz
Institution: Kahramanmaraş Sütçü İmam University
Language: English
Subfield: Ophthalmology
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
OpenAlex ID: W4400331648