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