%0 Journal Article
%T Beh£¿et¡¯s Disease and Intracardiac Thrombosis: A Report of Three Cases
%A Nur£¿en D¨¹zg¨¹n
%A Orhan K¨¹£¿¨¹k£¿ahin
%A Kayhan £¿etin Atasoy
%A Canan Togay I£¿£¿kay
%A Demet Menek£¿e Gerede
%A Ay£¿e Erden
%A Seda Kaynak £¿ahap
%A Muhammed Arif £¿bi£¿
%A A£¿k£¿n Ate£¿
%J Case Reports in Rheumatology
%D 2013
%I Hindawi Publishing Corporation
%R 10.1155/2013/637015
%X We present three patients with Beh£¿et¡¯s disease associated with intracardiac thrombus and pulmonary vascular involvement. One of these patients had also Budd-Chiari syndrome. All patients were treated with corticosteroid plus monthly intravenous cyclophosphamide as first line treatment and with no recurrences. Immunosuppressive therapy was successful in the treatment of intracardiac thrombus and also in the regression of pulmonary vascular thromboses in these patients. Intracardiac thrombus in Beh£¿et¡¯s disease is rarely seen. Beh£¿et¡¯s disease should be remembered in the differential diagnosis of the patients with intracardiac mass, especially in patients from the Mediterranean and Middle East populations. 1. Introduction Beh£¿et¡¯s disease (BD) is a multisystemic, chronic, inflammatory disorder of unknown etiology. In 1937, Dr. Beh£¿et first described the disease as a distinct clinical picture with a triple complex of recurrent oral aphthosis, genital ulcer, and iridocyclitis with hypopyon [1]. BD may also involve other locations such as skin, joint, central nervous system, gastrointestinal tract, lung, and cardiovascular system. The diagnosis is primarily based on clinical criteria because there is no specific diagnostic laboratory test. The histopathologic findings are also nonspecific. BD is frequent among the Mediterranean, Middle East, and Far Eastern populations. Beh£¿et¡¯s disease is recognized as a systemic vasculitis involving both arteries and veins of any size. Vascular involvement has occurred in one-third of patients. Most vascular events consist of recurrent superficial or deep vein thrombosis [2¨C4]. Arterial thrombosis is less frequent [3]. The cardiac findings were found in 1%¨C6% of BD cases in previous clinical series [5] and in 16.5% of cases in the Japanese autopsy registry [6]. Cardiac manifestations of BD include endocarditis, myocarditis, pericarditis, endomyocardial fibrosis, coronary arteritis with or without myocardial infarction, aneurysms of the coronary arteries, valve dysfunction, conduction system disturbances, and intracardiac thrombosis (ICT) [5, 7¨C9]. ICT is a rare manifestation of the disease [10¨C12]. Here we present the characteristic clinical findings in three cases with ICT related to BD and review the approach to treatment of ICT in BD patients. 2. Patient 1 A 22-year-old Turkish male presented to the emergency ward with complaints of fever, hypoesthesia on the left arm, and slurred speech that had lasted for a week. Medical history revealed previous attacks of intermittent fever together with recurrent oral and genital
%U http://www.hindawi.com/journals/crirh/2013/637015/