Lower Extremity Vein Thrombosis And Recurrence in Patients with Behcetʼs Syndrome: How And When?

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AbstractWe aimed to investigate the risk and time to recurrence of venous thrombosis (VT) in patients with BS, focusing on clinical features and laboratory parameters.A total of 67 BS patients with (n=32) and without (n=35) venous thrombosis (VT) fulfilled the diagnostic criteria of the International Criteria for Behcet’s Disease (ICBD) and were included in the study. Clinical features (onset of BS-related symptoms, presence of VT relapse and cutaneous ulcer, and the results of vascular system imaging), demographical data, duration of symptoms, time to diagnosis, delayed time to diagnosis, and patient follow-up periods were retrospectively obtained from medical records. Disease activity was assessed using the Behcet’s Disease Current Activity Form (BDCAF).VT was statistically more common in the male population. In the VT group, superficial thrombophlebitis (STF) was more frequent, while papulopustular lesions (PPL) and arthritis were also observed more often compared to the non-VT group. Median time to VT onset was 2 years (minimum: 0–27). The first episode of VT occurred within the first 5 years of disease onset in 68.75% (n=22/32) of patients. VT recurrence occurred in 21.8% of patients (n=7/32). The time to VT recurrence was a median of 3 years (min, max, 3–5 years) following the first VT episode. There was a statistically significant correlation between post-thrombotic cutaneous ulcers (PTCUs) and a positive pathergy test (p=0.048). Time to VT onset was 2.23 years in smokers and 6.38 years in non-smokers. This difference was found to be statistically significant when evaluated by a log-rank test (p=0.05).VT develops earlier in BS patients who smoke and have a family history of BS. One of the unique findings of our study is that pathergy test positivity predicts the risk of developing PTCUs. Although VT is most common within the first 5 years of the BS, VT recurrence occurs within the first 10 years.