title: Left ventricular intracardiac thrombus in a patient with Behçet disease successfully treated with immunosuppressive agents without anticoagulation: a case report and review of the literature.
abstract: Behçet disease (BD) is a chronic multisystem disorder with vasculitis underlying its systemic manifestations. Cardiac involvement and particularly left ventricular intracardiac thrombus are rarely diagnosed in the course of BD and are often associated with poor prognosis. The causes of intracardiac thrombi are unknown. It is plausible that specific proinflammatory pathways resulting in the endothelial cell injury and hypercoagulation contribute to the formation of thrombotic masses in the heart. Known thrombophilic factors such as methylenetetrahydrofolate reductase gene mutations, factor V Leiden mutation, proteins S and C, antithrombin III, activated protein C resistance, and antiphospholipid antibodies may contribute to the formation of intracardiac thrombi in BD. We report a case of a 24-year-old male patient with BD presented with left ventricular thrombus. Transthoracic echocardiography allowed to describe and monitor such a rare cardiac manifestation of the disease. A combination of high-dose corticosteroid and azathioprine successfully dissolved intracardiac thrombus within ten days without anticoagulation.
authors.affiliation: Nasonova Research Institute of Rheumatology, Russian Academy of Sciences, Kashirskoe shosse 34A, 115522, Moscow, Russia. talisitsyna@rambler.ru.
authors.forename: Tatiana
authors.initials: T
authors.lastname: Lisitsyna
authors.affiliation: Nasonova Research Institute of Rheumatology, Russian Academy of Sciences, Kashirskoe shosse 34A, 115522, Moscow, Russia. zalekberova@inbox.ru.
authors.forename: Zemfira
authors.initials: Z
authors.lastname: Alekberova
authors.affiliation: Nasonova Research Institute of Rheumatology, Russian Academy of Sciences, Kashirskoe shosse 34A, 115522, Moscow, Russia. pavelow@mail.ru.
authors.forename: Pavel
authors.initials: P
authors.lastname: Ovcharov
authors.affiliation: Nasonova Research Institute of Rheumatology, Russian Academy of Sciences, Kashirskoe shosse 34A, 115522, Moscow, Russia.
authors.forename: Alexander
authors.initials: A
authors.lastname: Volkov
authors.affiliation: Nasonova Research Institute of Rheumatology, Russian Academy of Sciences, Kashirskoe shosse 34A, 115522, Moscow, Russia.
authors.forename: Julia
authors.initials: J
authors.lastname: Korsakova
authors.affiliation: Nasonova Research Institute of Rheumatology, Russian Academy of Sciences, Kashirskoe shosse 34A, 115522, Moscow, Russia. socrat@irramn.ru.
authors.forename: Evgeni
authors.initials: E
authors.lastname: Nasonov
mesh_terms: D000305:Adrenal Cortex Hormones / Q000008:administration & dosage*; D000925:Anticoagulants / Q000627:therapeutic use; D001379:Azathioprine / Q000008:administration & dosage*; D001528:Behcet Syndrome / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy*; D004359:Drug Therapy, Combination; D006331:Heart Diseases / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology; D006352:Heart Ventricles / Q000000981:diagnostic imaging; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage*; D008297:Male; D013927:Thrombosis / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology; D013997:Time Factors; D016896:Treatment Outcome; D014463:Ultrasonography; D055815:Young Adult
chemical_list: D000305:Adrenal Cortex Hormones; D000925:Anticoagulants; D007166:Immunosuppressive Agents; D001379:Azathioprine
keywords: Anticoagulants; Behcet disease; Immunosuppressive treatment; Intracardiac thrombus; Left ventricle; Spontaneous echocardiographic contrast