title: Good response to infliximab in a patient with deep vein thrombosis associated with Behçet disease.
abstract: Vascular involvement is a lethal complication in Behçet disease. It is often refractory to conventional therapy such as steroids and immunosuppressants in addition to anticoagulants. We describe here successful treatment with the anti-tumor necrosis factor-alpha (anti-TNF-α) antibody, infliximab, in a patient with Behçet disease presenting with deep vein thrombosis. A 60-year-old man with Behçet disease complained of edema and pain in the lower extremities. Computed tomography revealed a thrombosis extending from the popliteal vein to the inferior vena cava at the level of the renal vein and which recurred despite combination therapy of steroid and immunosuppressants such as cyclosporine, azathioprine, and methotrexate. The patient was then administered infliximab (5 mg/kg) in weeks 0 and 2 and every 4 weeks thereafter. Clinical and laboratory findings improved after the infliximab therapy. Computed tomography of the abdomen and lower extremities showed a reduction of the thrombosis. No severe adverse events occurred during the clinical course. Although further studies are needed to confirm the efficacy and safety of its use, anti-TNF-α antibody may be worth considering as treatment for refractory venous thrombosis in patients with Behçet disease.
authors.affiliation: First Department of Internal Medicine, Osaka Medical College, Daigaku-Machi 2-7, Takatsuki, Osaka 569-8686, Japan. in1307@poh.osaka-med.ac.jp
authors.forename: Shuzo
authors.initials: S
authors.lastname: Yoshida
authors.forename: Tohru
authors.initials: T
authors.lastname: Takeuchi
authors.forename: Ayaka
authors.initials: A
authors.lastname: Yoshikawa
authors.forename: Takuro
authors.initials: T
authors.lastname: Ozaki
authors.forename: Yohei
authors.initials: Y
authors.lastname: Fujiki
authors.forename: Kenichiro
authors.initials: K
authors.lastname: Hata
authors.forename: Shigeki
authors.initials: S
authors.lastname: Makino
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Hanafusa
mesh_terms: D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D018501:Antirheumatic Agents / Q000627:therapeutic use*; D001379:Azathioprine / Q000627:therapeutic use; D001528:Behcet Syndrome / Q000150:complications / Q000188:drug therapy*; D016572:Cyclosporine / Q000627:therapeutic use; D004351:Drug Resistance; D057915:Drug Substitution; D004359:Drug Therapy, Combination; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D000069285:Infliximab; D008297:Male; D008727:Methotrexate / Q000627:therapeutic use; D008875:Middle Aged; D012008:Recurrence; D016896:Treatment Outcome; D020246:Venous Thrombosis / Q000188:drug therapy* / Q000209:etiology
chemical_list: D000911:Antibodies, Monoclonal; D018501:Antirheumatic Agents; D005938:Glucocorticoids; D007166:Immunosuppressive Agents; D016572:Cyclosporine; D000069285:Infliximab; D001379:Azathioprine; D008727:Methotrexate