Intracardiac thrombus in Beh？et's disease: Two case reports

intracardiac thrombus is a rare complication of Beh？et's disease. As shown in our patients, medical treatment should be considered as the first line.Behcet's disease (BD) is a multisystemic inflammatory disease with a clinical spectrum that has greatly expanded since it was first described in 1937 as a triple complex of recurrent oral genital ulcers and uveitis. Cardiac involvement is extremely rare and often associated with poor prognosis [1]. We report two patients with a large intracardiac thrombus (ICTs) out of a series of 130 patients with BD.A 20-year-old Tunisian man with a three weeks history of dyspnoea, cough and haemoptysis was admitted. At the age of 18, he had suffered from painful oral and genital ulcerations and polyarthralgias. At that time, examination revealed bilateral papillary oedema and brain magnetic resonance imaging showed superior sagittal and left lateral thromboses. The patient was given oral prednisone at the dose of 1 mg/kg/day that was tapered gradually and colchicine 1 mg/day in addition to acenocoumarol to maintain International Normalized Ratio between 2 and 3. These medications were discontinued per the patient 7 months later which resulted in the recurrence of aphtous ulcerations and papulopustular eruptions episodes.On physical examination the patient had fever, face and neck oedema, prominent superficial thoracic venous collaterals, and pseudofolliculitis lesions. There was evidence of penile and scrotal scarring and minor aphthae on the buccal mucosa. Blood pressure was 110/80 mm Hg and pulse rate 100/min.As to laboratory tests, haemoglobin concentration was of 9 g/dl, erythrocyte sedimentation rate of 60 mm/hr and C reactive protein concentration of 19 mg/l (normal < 2 mg/l). Renal and liver function tests were normal. Levels of serum IgG and IgM anticardiolipin, protein C, protein S, antithrombine III and total homocysteine were within the normal range. Electrocardiogram showed sinus rhythm tachycardia with no other abnormali