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M H. Houman Department of internal medicine

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Presentation on theme: "M H. Houman Department of internal medicine"— Presentation transcript:

1 Characteristics of Deep venous thrombosis in Tunisian Behçet's disease patients.
M H. Houman Department of internal medicine University hospital of la Rabta Tunis Tunisia

2 Objectives: To determine the frequency, the clinical characteristics and course of DVT in BD Tunisian Patients to define a subgroup of patients at high risk for this complication.

3 Patients and Methods: Retrospective review of 260 Patients with BD (ISG criteria) seen in the Department of Internal Medicine of the University Hospital La Rabta in Tunisia, from 1990 to 2006.

4 Patients and Methods: The diagnosis of DVT was made in all cases using conventional venous angiography, venous ultrasonography and/or thoracic or abdominal computed tomography. Patients were divided in two subgroups according to the occurrence of DVT.

5 Patients and Methods: Protein S, protein C and AT: 51 patients
aCL and antiß2GP1 Abs: 27 patients HLA B51: 41 patients. data were analyzed using SPSS 11.0.

6 Results

7 Results 86 patients (33%) had DVT. 74 men and 12 women (M/F = 6.16).
Mean age at DVT onset: years. Mean delay: 4 years after BD onset In 11 cases, DVT revealed BD

8 158 locations of DVT were detected.
Results 158 locations of DVT were detected. Nbr patients: 86 Nbr locations 37 (43.02%) 1 33 (38.37%) 2 10 (11.63%) 3 5 (5.81%) 4 1 (1.16%) 5 57% of our patients showed more than 1 location

9 Results: 158 locations of DVT were detected.
Nbr (158) % Lower extremities 86 54.43 inferior vena cava 18 11.4 Superior vena cava 17 10.76 Pulmonary embolism 16 10.13 Cerebral veins 13 8.23 Jugular Veins 4 2.53 Sup Hepatic Veins 3 1.9 Upper extremities 1 0.63

10 Lower extremity DVT

11 Results: IgG Acl + in 8/27 aß2GP1 + in 1 patient
Protein C deficiency 2 cases Protein S in one case. No patient with Anti-thrombin deficiency No difference between patients with/without DVT

12 Results: Treatment All patients: anticoagulant agents and colchicine
Corticosteroids: prescribed to 51 (61.4%) patients and monthly IV pulses of cyclophosphamide were added to 25 (30%) cases

13 Results: Course of DVT Complete clinical recovery:30 cases (47.6%)
Available in 63 cases Complete clinical recovery:30 cases (47.6%) Chronic venous insufficiency:12 (19%). Recurrence of DVT: 21 (33.4%) 2 patient died.

14 Results: DVT Recurrence
15/54 (27.7%) patients treated with corticosteroids, 6/32 (18.7%)patients with no corticosteroids (p = 0.001).

15 Results: patients CC + 68 CC- 17 Lower extremities 71 14
inferior vena cava 18 Superior vena cava Pulmonary embolism 15 1 Cerebral veins 12 Jugular Veins 4 Sup Hepatic Veins 3 Upper extremities

16 Results: 0.762 4 (66.7%) 14 (60.9%) HLA B51 27 (39.7%) Neurological
27 (39.7%) Neurological 0.130 8 (47%) 19 (27.9%) Articular 0.007 1 (6.3%) 27 (40.3%) Ocular 0.144 9 (90%) 33 (67.3%) PT 0.599 3 (17.6%) 13 (19%) EN 0.552 11 (64.7%) 49 (72%) PSF 0.575 15 (88.2%) 61 (89.7%) AG 0.407 31 24.33 Age 0.446 14 (82.4%) 59 (86.8%) Males P Corticosteroids 17 Corticosteroids + 68

17 Results: Clinical features of BD in patients with and without DVT
174 With DVT 86 P Males 114 (65.9%) 74 (86%) 0.001 Age 28.6 29.55 0.482 AG 138 (80.2%) 77 (89.5%) 0.059 PSF 122 (70.5) 61 (70.9) 0.946 EN 39 (22.5) 16 (18.6) 0.465 PT 65 (58) 42 (70) 0.123 Ocular 98 (57) 28 (33.3) <0.0001 Articular 73 (42) 27 (32.5) 0.093 Neurological 36 (20.8) 27 (31.4) 0.061 Entero 3 (1.7) 1 (1.2) 0.749 HLA B51 41 (50.6) 18 (62.1) 0.289

18 Conclusion In our series Frequency of DVT is rather high: 33%
57% of our patients showed more than 1 location Lower extremities the + frequent location: 54.4% Recurrence of DVT was seen in 33.4% of cases DVT recurrence significantly + frequent in patients in whom corticosteroids were added!!

19 Conclusion In our series No correlation with aCL and aß2GP1 Abs
No correlation with Prot S, C & AT deficiencies Hence, thrombosis in BD seems to be related more to vasculitis than to clotting disorders.

20 Conclusion our results showed also that DVT occurs
+ frequently in males with GA & Neuro involvement Less frequently in those with ocular disease


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