title: Pulmonary thromboembolism in patient with coexistence of Behçet's disease and antiphospholipid syndrome.
abstract: Pulmonary thromboembolism (PTE) is rarely reported in Behçet's disease (BD) due to its distinctive thrombus-forming mechanism. In BD, the inflammation on vessel walls causes venous thrombosis. The thrombi are considered to be tethered to the inflamed walls making embolization less frequent. Thus, immunosuppressive agents are the mainstay of treatment. However, the necessity of anticoagulation therapy is controversial because of its uncertain efficacy of resolving thrombi and the possibility of fatal side effects of hemorrhage. A 25-year-old man with recurrent oral aphthae visited with abrupt onset of dyspnea and chest pain. Based on history, imaging studies and laboratory results, he was diagnosed with BD with vascular involvement and antiphospholipid syndrome (APS), causing PTE from deep vein thrombosis. The co-existing APS may have further promoted the thrombosis, shifting his blood profile toward the hypercoagulable state. Immunosuppressive therapy with glucocorticoid and azathioprine, and concomitant anticoagulation with warfarin were achieved successfully without any fatal complications. When atypical features of vascular involvement in BD develop, other coexisting diseases should be considered to design an optimal therapeutic plan.
authors.affiliation: Division of Rheumatology, Department of Internal Medicine, Konkuk University Medical Center, Seoul, Korea.
authors.forename: Jun-Hyun
authors.initials: JH
authors.lastname: Kim
authors.affiliation: Division of Rheumatology, Department of Internal Medicine, Konkuk University Medical Center, Seoul, Korea.
authors.forename: Kyung-Ann
authors.initials: KA
authors.lastname: Lee
authors.affiliation: Division of Rheumatology, Department of Internal Medicine, Konkuk University Medical Center, Seoul, Korea.
authors.forename: Min-Young
authors.initials: MY
authors.lastname: Jung
authors.affiliation: Division of Rheumatology, Department of Internal Medicine, Konkuk University Medical Center, Seoul, Korea.
authors.forename: Ah-Ran
authors.initials: AR
authors.lastname: Kim
authors.affiliation: Division of Rheumatology, Department of Internal Medicine, Konkuk University Medical Center, Seoul, Korea.
authors.forename: Jeong-Min
authors.initials: JM
authors.lastname: Yoon
authors.affiliation: Division of Rheumatology, Department of Internal Medicine, Konkuk University Medical Center, Seoul, Korea.
authors.forename: Hyoung-Joon
authors.initials: HJ
authors.lastname: Shim
authors.affiliation: Division of Rheumatology, Department of Internal Medicine, Konkuk University Medical Center, Seoul, Korea.|Division of Rheumatology, Department of Internal Medicine, Konkuk University School of Medicine, Seoul, Korea.
authors.forename: Sang-Heon
authors.initials: SH
authors.lastname: Lee
authors.affiliation: Division of Rheumatology, Department of Internal Medicine, Konkuk University Medical Center, Seoul, Korea.
authors.forename: Ho-Youn
authors.initials: HY
authors.lastname: Kim
authors.affiliation: Division of Rheumatology, Department of Internal Medicine, Konkuk University Medical Center, Seoul, Korea.|Division of Rheumatology, Department of Internal Medicine, Konkuk University School of Medicine, Seoul, Korea.
authors.forename: Hae-Rim
authors.initials: HR
authors.lastname: Kim
mesh_terms: D000328:Adult; D000925:Anticoagulants / Q000627:therapeutic use; D016736:Antiphospholipid Syndrome / Q000097:blood / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D001528:Behcet Syndrome / Q000097:blood / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D000072226:Computed Tomography Angiography; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008297:Male; D010690:Phlebography / Q000379:methods; D011655:Pulmonary Embolism / Q000097:blood / Q000000981:diagnostic imaging / Q000209:etiology* / Q000517:prevention & control; D012307:Risk Factors; D016896:Treatment Outcome; D020246:Venous Thrombosis / Q000097:blood / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000209:etiology*
chemical_list: D000925:Anticoagulants; D007166:Immunosuppressive Agents
keywords: Behçet's disease; anticoagulation; antiphospholipid syndrome; deep vein thrombosis; pulmonary thromboembolism