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Major vascular involvement in Behçet’s disease: a retrospective study of 796 patients

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Abstract

Behçet’s disease (BD) is a multi-systemic inflammatory disorder which can affect all types and sizes of blood vessels. This study aims to evaluate the prevalence and characteristics of vascular involvement in BD. Among 796 patients diagnosed with BD, 102 patients (81 male, 21 female) with vascular involvement were included, whose detailed clinical characteristics were recorded. The diagnosis of vascular lesions was made on clinical signs, by Doppler ultrasonography, and/or angiography using computed tomographic or magnetic resonance techniques. Vascular involvement occurred in 12.8 % of BD patients. Male to female ratio was 3.86:1. Mean age at onset of vascular involvement was 29.5 ± 11.3 years. Vascular lesion was the initial sign of BD in 28 patients, accounting for 27.5 %. Of 102 BD patients with vascular involvement, 72 had venous lesions (70.6 %) and 56 had arterial lesions (54.9 %), among which 26 (25.5 %) patients had both venous and arterial involvements. Female BD patients were more often involved with arterial lesions, whereas male BD patients developed venous lesions more often than females, P = 0.000. The most common type of vascular involvement was deep venous thrombosis in lower extremities (n = 49), other affected venous sites including inferior vena cava, superior vena cava, and cerebral venous. The prominent type of arterial lesions was dilatation (n = 25, including 24 cases of aneurysms); other types included eight cases of occlusion and 23 cases of stenosis. The main locations of arterial lesions were the aorta (n = 19), lower extremity arteries (n = 15), pulmonary arteries (n = 13), coronary arteries (n = 5), and subclavian arteries (n = 5). Compared with those without vascular lesions, ocular involvement, genital ulcers, and arthritis were significantly less frequent among patients with vasculo-BD (23.5 vs 35.2 %, P = 0.024; 54.9 vs 76.5 %, P = 0.000; 19.6 vs 30.5 %, P = 0.026), whereas a higher frequency of cardiac involvement was found in vasculo-BD patients (20.6 vs 3.6 %, P = 0.000). Vascular involvement is a complication in BD patients. This study illustrated that venous lesions are more frequently involved than arterial lesions. Vascular lesions correlated with a high frequency of cardiac involvement and a low incidence of ocular lesions, genital ulcers, and arthritis.

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Acknowledgments

This work was supported by The National Natural Science Foundation of China (no. 81172858; 81202360).

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Authors and Affiliations

  1. Department of Rheumatology, Peking Union Medical Hospital, 100032, Beijing, China

    Yunyun Fei, Qingjun Wu, Wen Zhang, Yan Zhao, Xiaofeng Zeng & Fengchun Zhang

  2. Respiratory Department, Beijing General Hospital of Jingmei Group, Beijing, 102300, China

    Xuemei Li

  3. Department of Rheumatology, Zaozhuang Hospital of Traditional Chinese Medicine, Zaozhuang, China

    Sen Lin

  4. Department of Vascular Surgery, Peking Union Medical Hospital, 100032, Beijing, China

    Xiaojun Song

  5. Department of Cardiology, Peking Union Medical Hospital, 100730, Beijing, China

    Yanlin Zhu

  6. Department of Radiology, Peking Union Medical Hospital, 100730, Beijing, China

    Xin Gao

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  1. Yunyun Fei
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  8. Wen Zhang
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Correspondence to Wen Zhang.

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Fei, Y., Li, X., Lin, S. et al. Major vascular involvement in Behçet’s disease: a retrospective study of 796 patients. Clin Rheumatol 32, 845–852 (2013). https://doi.org/10.1007/s10067-013-2205-7

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  • DOI: https://doi.org/10.1007/s10067-013-2205-7

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