Document Detail


Cerebral venous thrombosis in Behçet's disease.
MedLine Citation:
PMID:  19333987     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To analyze the clinical findings, treatment, outcome, and prevalence of cerebral venous thrombosis (CVT) in a large cohort of patients with Behçet's disease (BD) from a single center. METHODS: We reported a series of 64 consecutive patients with CVT who fulfilled the international criteria for BD. Multivariate analysis was performed to define factors that affect prognosis. RESULTS: Among a cohort of 820 patients with BD, CVT was present in 64 (7.8%). Compared with BD patients without CVT, those with CVT had lower parenchymal central nervous system involvement (4.7% versus 28.7%; P = 0.0001) and higher extraneurologic vascular lesions (62.5% versus 38.8%; P = 0.03). Up to 90% of patients responded to anticoagulation therapy without severe hemorrhagic complications. Neither steroid nor immunosuppressant use provided better outcome. Severe visual loss due to optic atrophy was the main complication of CVT, being found in 15% of patients. In multivariate analysis, papilledema (odds ratio [OR] 7.1, 95% confidence interval [95% CI] 1.6-31.9) and concurrent prothrombotic risk factors (OR 4.6, 95% CI 1.1-20.2) were independently associated with the occurrence of sequelae. Factors associated with relapse of thrombosis were concurrent prothrombotic risk factors (hazard ratio [HR] 4.9, 95% CI 1.5-15.4) and a peripheral venous thrombosis (HR 2.8, 95% CI 0.7-10.5). After a mean +/- SD followup of 8.2 +/- 6.9 years, 4 deaths unrelated to CVT were noted. CONCLUSION: CVT in patients with BD may result in serious neurologic outcomes. Anticoagulation represents a safe and effective therapy. Extensive investigation of prothrombotic disorders should be considered.
Authors:
D Saadoun; B Wechsler; M Resche-Rigon; S Trad; D Le Thi Huong; A Sbai; D Dormont; Z Amoura; P Cacoub; J C Piette
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Arthritis and rheumatism     Volume:  61     ISSN:  0004-3591     ISO Abbreviation:  Arthritis Rheum.     Publication Date:  2009 Apr 
Date Detail:
Created Date:  2009-04-07     Completed Date:  2009-05-26     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0370605     Medline TA:  Arthritis Rheum     Country:  United States    
Other Details:
Languages:  eng     Pagination:  518-26     Citation Subset:  AIM; IM    
Affiliation:
Hôpital Pitié-Salpétrière and Pierre et Marie Curie-Paris VI University, Paris, France. david.saadoun@psl.aphp.fr
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MeSH Terms
Descriptor/Qualifier:
Adult
Anticoagulants / therapeutic use
Behcet Syndrome / complications*
Cohort Studies
Female
Humans
Intracranial Thrombosis / diagnosis,  drug therapy,  epidemiology*
Male
Multivariate Analysis
Prevalence
Prognosis
Retrospective Studies
Risk Factors
Treatment Outcome
Venous Thrombosis / diagnosis,  drug therapy,  epidemiology*
Chemical
Reg. No./Substance:
0/Anticoagulants

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