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Resolution of intracardiac and pulmonary thrombi without anticoagulation in a patient with Behçet's disease: a case report

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Department of Internal Medicine, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan. drsamrah@msn.com

CER6161 Submission on line
2013 Vol.31, N°3 ,Suppl.77 - PI 0090, PF 0092
Case Report

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Rheumatology Article

 

Abstract

Intracardiac and pulmonary thrombi are rare but serious manifestations of Behçet`s disease, the treatment of such cases is a challenge to the treating physician and use of anticoagulants can hold a great risk to some patients. We report a patient who was found to have multiple right intraventricular and bilateral pulmonary artery thrombi and was clinically diagnosed with Behçet`s disease. Early in the course of his treatment, the patient developed massive haemoptysis which precluded the further use of anticoagulants. The patient was treated with immunosuppressants alone and had complete resolution of his symptoms and documented resolution of the thrombi. In a review of the literature, only 3 out of around 50 patients reported to have intracardiac thrombi complicating Behçet`s disease were treated without anticoagulants (1, 2) even though there is no clear evidence to support the benefit of anticoagulation to treat arterial or thrombotic lesions (3). We conclude that intracardiac thrombi in patients with Behçet`s disease may resolve with immunosuppressants without anticoagulation, which is especially important in patients with contraindication to anticoagulation.

PMID: 23463899 [PubMed]

Received: 24/11/2012 - Accepted : 17/01/2013 - In Press: 04/03/2013 - Published: 09/09/2013