Abstract
BackgroundCardiac and vascular involvement in Behçet disease (BD), also referred as vasculo BD, is frequent. We aimed to describe clinical characteristics, predictive factors and management of vasculo BD in the Tunisian context.MethodsWe retrospectively studied 213 records of all BD patients followed between January 2004 and May 2016 in the Internal Medicine Department and who fulfilled the ISGBD criteria. We described first clinical features of BD with cardiac and vascular involvement then predictive factors were studied in univariate then multivariate analysis.ResultsAmong the 213 patients, 64 (30%) were diagnosed as having vasculo BD. The mean age at diagnosis was 31.5 years. About 81.25% of them were males and 18.75% females. Vascular involvement associated or not with cardiac involvement was found in 64 patients (30%). Deep venous thromboses are most common (62.5%) compared with superficial ones (23.4%), pulmonary arterial thrombosis (14.1%) or aneurysms (9.4%). Cardiac involvement is ranging from pericarditis (1.6%) to intra cardiac thrombosis (3.1%) and myocardial infarction (1.6%). Predictive factors associated with cardiac and vascular involvement in BD are male gender (OR = 3.043, 95% CI = 1.436–6.447, p = 0.004), erythema nodosum (OR = 4.134, 95% CI = 1.541–11.091, p = 0.005) and neurologic involvement (OR = 2.46, 95% CI = 1.02–5.89, p = 0.043).ConclusionCardiac and vascular involvement in BD is frequent in the Tunisian context with a broad spectrum of manifestations ranging from vascular involvement to cardiac one. Male gender, patients with erythema nodosum or neurologic involvement are prone to develop cardiac or vascular features of BD needing therefore a close monitoring.
Highlights
Cardiac and vascular involvement in Behçet disease (BD), referred as vasculo BD, is frequent
Predictive factors of cardiac and vascular involvement found in our cohort were male gender (OR = 3.043, 95% confidence interval (95% CI) = 1.436–6.447, p = 0.004), erythema nodosum (OR = 4.134, 95% CI = 1.541–11.091, p = 0.005) and neurologic involvement
There is a broad spectrum of cardiac and vascular involvement in BD patients and we found that vascular manifestations are more frequent than cardiac ones
Summary
Cardiac and vascular involvement in Behçet disease (BD), referred as vasculo BD, is frequent. Behçet disease (BD) is a systemic vasculitis of unknown origin with a remitting and relapsing course. It is prevalent along the “silk road” extending from Japan to the Middle Eastern and the Mediterranean countries [1]. BD is mainly characterized by recurrent oral and genital aphthosis associated with other cutaneous and ocular manifestations It may involve, in a lesser extent, the gastro intestinal tract, joints and the central nervous system. In a lesser extent, the gastro intestinal tract, joints and the central nervous system These clinical signs seem to vary in prevalence according to the ethnic groups and geographical regions
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