Cerebral venous sinus thrombosis in Behçet’s disease: A retrospective single-centre study
Yıl: 2022 Cilt: 14 Sayı: 1 Sayfa Aralığı: 7 - 14 Metin Dili: İngilizce DOI: 10.4274/raed.galenos.2022.35220 İndeks Tarihi: 27-06-2022
Cerebral venous sinus thrombosis in Behçet’s disease: A retrospective single-centre study
Öz: Objective: This study aims to analyze the clinical, laboratory findings,
treatments and prognosis of Behçet’s disease (BD)-associated cerebral
venous sinus thrombosis (CVST) and to compare the clinical features of
BD patients with and without CVST.
Methods: In this single-center retrospective study, we reported a
series of 24 consecutive CVST patients (20 males and 4 females; mean
age 34±12 years) were diagnosed with BD according to international
study group criteria. The control group included 36 (24 males and 12
females; mean age 32±8 years) consecutive patients with BD without
CVST from the same center.
Results: Headache (n=20, 83.3%) was the most common complaint at
admission in patients with BD-associated CVST. In comparison between
BD cases with and without CVST, extracranial vascular involvement was
more frequent in the BD-associated CVST patients (p=0.03). Twentythree (95.8%) patients received corticosteroid (CS) treatment. A total
of 8 BD-associated CVST patients received anti-tumor necrosis factoralpha (anti TNF-α) treatment. There was no significant difference
in the rate of CS use before and after anti-tumor necrosis factor-α
(TNF-α) treatment (p=0.345) but CS dose was significantly reduced
after treatment (p=0.018). When patients with BD- associated CVST
who receive or did not receive anti-TNF-α treatment compared, on
cranial imaging, thrombosis was significantly less in patients received
anti TNF-α treatment than who did not (p=0.02).
Conclusion: When the CVST was detected in young men patients
with headache, BD should come to mind and patients should also
be evaluated in this respect. As the risk of extracranial vascular
involvement increases in such patients, they should be systematically
evaluated in terms of vascular involvement. Although CS treatment
could not be stopped completely with anti TNF-α drugs, it could be
reduced. Significant radiological improvement was observed with antiTNF-α treatment.
Anahtar Kelime: Behçet hastalığında serebral venöz sinüs trombozu: Retrospektif tek merkezli bir çalışma
Öz: Amaç: Bu çalışmanın amacı, Behçet hastalığı (BH) ile ilişkili serebral
venöz sinüs trombozunun (SVST) klinik, laboratuvar bulgularını,
tedavilerini ve prognozunu analiz etmek ve SVST olan ve olmayan BH
hastalarının klinik özelliklerini karşılaştırmaktır.
Yöntem: Bu tek merkezli retrospektif çalışmaya, uluslararası çalışma
grubu kriterlerelerine göre BH tanısı konan 24 ardışık SVST hastası (20
erkek ve 4 kadın; ortalama yaş 34±12 yıl) dahil edildi. Kontrol grubu
aynı merkezden 36 (24 erkek ve 12 kadın; ortalama yaş 32±8 yıl)
SVST’si olmayan ardışık BH hastasıydı.
Bulgular: Baş ağrısı (n=20, %83,3) BH ile ilişkili SVST’li hastalarda
başvuru sırasında en sık görülen şikayetti. SVST olan ve olmayan BH
olguları karşılaştırıldığında, BH ile ilişkili SVST hastalarında ekstrakraniyal
vasküler tutulum daha sıktı (p=0,03). Yirmi üç (%95,8) hasta
kortikosteroid (KS) tedavisi aldı. Toplam 8 BH ile ilişkili SVST hastası,
anti-tümör nekroz faktör (TNF-α) tedavisi aldı. TNF-α tedavisi öncesi
ve sonrası KS kullanım oranında anlamlı fark bulunmadı (p=0,345),
ancak tedavi sonrası KS dozu anlamlı olarak azalmıştı (p=0,018). BH
ile ilişkili SVST olan ve anti-TNF-α tedavisi alan ve almayan hastalar
karşılaştırıldığında, kraniyal görüntülemede, anti TNF-α tedavisi
alan hastalarda tromboz, almayanlara göre anlamlı olarak daha azdı
(p=0,02).
Sonuç: Baş ağrısı olan genç erkek hastalarda SVST saptandığında akla
BH gelmeli ve hastalar bu açıdan değerlendirilmelidir. Bu hastalarda
ekstrakraniyal vasküler tutulumu riski arttığından, vasküler tutulum
açısından sistemik olarak değerlendirilmelidirler. Anti TNF-α ilaç
tedavisi ile KS tedavisi tamamen kesilesemese de, dozu azaltılabilir.
Anti-TNF-α tedavi ile belirgin radyolojik iyileşme gözlendi.
Anahtar Kelime: Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
- 1. Hatemi G, Seyahi E, Fresko I, Talarico R, Hamuryudan V. One year in review 2018: Behçet’s syndrome. Clin Exp Rheumatol 2018;36(6 Suppl 115):13-27.
- 2. Esatoglu SN, Kutlubay Z, Hatemi G. Highlights of the 18th International Conference on Behçet’s syndrome. Clin Exp Rheumatol 2018;36(6 Suppl 115):3-12.
- 3. Aydin AE, Gunduz O, Sari I, Saatci AO, Yilmaz E, Akkoc N. Papilledema Caused by Cerebral Venous Sinus Thrombosis in a Patient With Behcet Disease. Journal of Clinical Rheumatology: Practical Reports on Rheumatic & Musculoskeletal Diseases 2013;19:52.
- 4. Shi J, Huang X, Li G, et al. Cerebral venous sinus thrombosis in Behçet’s disease: a retrospective case-control study. Clin Rheumatol 2018;37:51-7.
- 5. Wechsler B, Sbaï A, Du-Boutin LT, Duhaut P, Dormont D, Piette JC. [Neurological manifestations of Behçet’s disease]. Rev Neurol (Paris) 2002;158(10 Pt 1):926-33.
- 6. Lakhanpal S, Tani K, Lie JT, Katoh K, Ishigatsubo Y, Ohokubo T. Pathologic features of Behçet’s syndrome: a review of Japanese autopsy registry data. Hum Pathol 1985;16:790-5.
- 7. Bolek EC, Sari A, Kilic L, et al. Clinical features and disease course of neurological involvement in Behcet’s disease: HUVAC experience. Mult Scler Relat Disord 2020;38:101512.
- 8. Saadoun D, Wechsler B, Resche-Rigon M, et al. Cerebral venous thrombosis in Behçet’s disease. Arthritis Rheum 2009;61:518-26.
- 9. Saip S, Akman-Demir G, Siva A. Neuro-Behçet syndrome. Handb Clin Neurol 2014;121:1703-23.
- 10. Uluduz D, Midi I, Duman T, et al. Behçet’s disease as a causative factor of cerebral venous sinus thrombosis: subgroup analysis of data from the VENOST study. Rheumatology (Oxford) 2019;58:600-8.
- 11. Wechsler B, Vidailhet M, Piette JC, et al. Cerebral venous thrombosis in Behçet’s disease: clinical study and long-term follow-up of 25 cases. Neurology 1992;42(3 Pt 1):614-8.
- 12. Bank I, Weart C. Dural sinus thrombosis in Behçet’s disease. Arthritis Rheum 1984;27:816-8.
- 13. Lo Monaco A, La Corte R, Caniatti L, Borrelli M, Trotta F. Neurological involvement in North Italian patients with Behçet disease. Rheumatol Int 2006;26:1113-9.
- 14. Ksiaa I, Abroug N, Kechida M, et al. [Eye and Behçet’s disease]. J Fr Ophtalmol 2019;42:626-41.
- 15. Aguiar de Sousa D, Mestre T, Ferro JM. Cerebral venous thrombosis in Behçet’s disease: a systematic review. J Neurol 2011;258:719-27.
- 16. Wu X, Li G, Huang X, et al. Behçet’s disease complicated with thrombosis: a report of 93 Chinese cases. Medicine (Baltimore) 2014;93:e263.
- 17. Tunc R, Saip S, Siva A, Yazici H. Cerebral venous thrombosis is associated with major vessel disease in Behçet’s syndrome. Ann Rheum Dis 2004;63:1693-4.
- 18. Esatoglu SN, Hatemi G. Update on the treatment of Behçet’s syndrome. Intern Emerg Med 2019;14:661-75.
- 19. Tatlican S. Behçet Hastalığı Tedavisinde Anti-TNF Ajanlar. Turk J Rheumatol 2009;24:27-38.
- 20. Kehribar DY, Ozgen M. Infliximab treatment in refractory vascular Behcet’s disease: A single-center experience. Vascular 2020;28:829-33.
- 21. Hatemi G, Christensen R, Bang D, et al. 2018 update of the EULAR recommendations for the management of Behçet’s syndrome. Ann Rheum Dis 2018;77:808-18.
- 22. Aksoy A, Yazici A, Omma A, et al. Efficacy of TNFα inhibitors for refractory vascular Behçet’s disease: A multicenter observational study of 27 patients and a review of the literature. Int J Rheum Dis 2020;23:256-61.
- 23. Kidd D, Steuer A, Denman AM, Rudge P. Neurological complications in Behçet’s syndrome. Brain 1999;122(Pt 11):2183-94.
- 24. Akman-Demir G, Serdaroglu P, Tasçi B. Clinical patterns of neurological involvement in Behçet’s disease: evaluation of 200 patients. The Neuro-Behçet Study Group. Brain 1999;122(Pt 11):2171-82.
- 25. Ferro JM, Canhão P, Stam J, Bousser MG, Barinagarrementeria F. Prognosis of cerebral vein and dural sinus thrombosis: results of the International Study on Cerebral Vein and Dural Sinus Thrombosis (ISCVT). Stroke 2004;35:664-70.
- 26. Desbois AC, Addimanda O, Bertrand A, et al. Efficacy of AntiTNFα in Severe and Refractory Neuro-Behcet Disease: An Observational Study. Medicine (Baltimore) 2016;95:e3550.
APA | AKYOL L, Aslan K, Gürbüz C, Ozgen M, Sayarlıoğlu M (2022). Cerebral venous sinus thrombosis in Behçet’s disease: A retrospective single-centre study. , 7 - 14. 10.4274/raed.galenos.2022.35220 |
Chicago | AKYOL Lutfi,Aslan Kerim,Gürbüz Cemal,Ozgen Metin,Sayarlıoğlu Mehmet Cerebral venous sinus thrombosis in Behçet’s disease: A retrospective single-centre study. (2022): 7 - 14. 10.4274/raed.galenos.2022.35220 |
MLA | AKYOL Lutfi,Aslan Kerim,Gürbüz Cemal,Ozgen Metin,Sayarlıoğlu Mehmet Cerebral venous sinus thrombosis in Behçet’s disease: A retrospective single-centre study. , 2022, ss.7 - 14. 10.4274/raed.galenos.2022.35220 |
AMA | AKYOL L,Aslan K,Gürbüz C,Ozgen M,Sayarlıoğlu M Cerebral venous sinus thrombosis in Behçet’s disease: A retrospective single-centre study. . 2022; 7 - 14. 10.4274/raed.galenos.2022.35220 |
Vancouver | AKYOL L,Aslan K,Gürbüz C,Ozgen M,Sayarlıoğlu M Cerebral venous sinus thrombosis in Behçet’s disease: A retrospective single-centre study. . 2022; 7 - 14. 10.4274/raed.galenos.2022.35220 |
IEEE | AKYOL L,Aslan K,Gürbüz C,Ozgen M,Sayarlıoğlu M "Cerebral venous sinus thrombosis in Behçet’s disease: A retrospective single-centre study." , ss.7 - 14, 2022. 10.4274/raed.galenos.2022.35220 |
ISNAD | AKYOL, Lutfi vd. "Cerebral venous sinus thrombosis in Behçet’s disease: A retrospective single-centre study". (2022), 7-14. https://doi.org/10.4274/raed.galenos.2022.35220 |
APA | AKYOL L, Aslan K, Gürbüz C, Ozgen M, Sayarlıoğlu M (2022). Cerebral venous sinus thrombosis in Behçet’s disease: A retrospective single-centre study. Ulusal Romatoloji Dergisi, 14(1), 7 - 14. 10.4274/raed.galenos.2022.35220 |
Chicago | AKYOL Lutfi,Aslan Kerim,Gürbüz Cemal,Ozgen Metin,Sayarlıoğlu Mehmet Cerebral venous sinus thrombosis in Behçet’s disease: A retrospective single-centre study. Ulusal Romatoloji Dergisi 14, no.1 (2022): 7 - 14. 10.4274/raed.galenos.2022.35220 |
MLA | AKYOL Lutfi,Aslan Kerim,Gürbüz Cemal,Ozgen Metin,Sayarlıoğlu Mehmet Cerebral venous sinus thrombosis in Behçet’s disease: A retrospective single-centre study. Ulusal Romatoloji Dergisi, vol.14, no.1, 2022, ss.7 - 14. 10.4274/raed.galenos.2022.35220 |
AMA | AKYOL L,Aslan K,Gürbüz C,Ozgen M,Sayarlıoğlu M Cerebral venous sinus thrombosis in Behçet’s disease: A retrospective single-centre study. Ulusal Romatoloji Dergisi. 2022; 14(1): 7 - 14. 10.4274/raed.galenos.2022.35220 |
Vancouver | AKYOL L,Aslan K,Gürbüz C,Ozgen M,Sayarlıoğlu M Cerebral venous sinus thrombosis in Behçet’s disease: A retrospective single-centre study. Ulusal Romatoloji Dergisi. 2022; 14(1): 7 - 14. 10.4274/raed.galenos.2022.35220 |
IEEE | AKYOL L,Aslan K,Gürbüz C,Ozgen M,Sayarlıoğlu M "Cerebral venous sinus thrombosis in Behçet’s disease: A retrospective single-centre study." Ulusal Romatoloji Dergisi, 14, ss.7 - 14, 2022. 10.4274/raed.galenos.2022.35220 |
ISNAD | AKYOL, Lutfi vd. "Cerebral venous sinus thrombosis in Behçet’s disease: A retrospective single-centre study". Ulusal Romatoloji Dergisi 14/1 (2022), 7-14. https://doi.org/10.4274/raed.galenos.2022.35220 |