Aşker Selvi, Aşker Müntecep, Gürsu Ozgür, Mercan Rıdvan, Timuçin Ozgür Bülent
Department of Chest Disease, Van Training and Research Hospital, Van, Turkey.
Case Rep Pulmonol. 2013;2013:492321. doi: 10.1155/2013/492321. Epub 2013 Jun 18.
Intracardiac thrombus, pulmonary artery aneurysms, deep vein thrombosis, and pulmonary thromboembolism are rarely seen symptoms of Behcet's disease. A 20-year-old female patient was admitted for complaints of cough, fever, palpitations, and chest pain. On the dynamic thorax computed tomograms (CT) obtained because of significantly enlarged hilar structures seen on chest radiograms, aneurysmal dilatation of the pulmonary artery segments bilaterally, chronic thrombus with collapse, and consolidation substances compatible with pulmonary embolism involving both lower lobes have been observed. It is learned that, four years ago, the patient had been diagnosed with Behcet's disease and received colchicine treatment but not regularly. The patient was hospitalized. On the transthoracic echocardiogram, a thrombosis with a dimension of 4.2 × 1.6 cm was recognized in the right ventricle. On abdomen CT, aneurysmal iliac veins and deep vein thrombus on Doppler ultrasonograms were diagnosed. At the controls after three months of immunosuppressive and anticoagulant therapies, some clinical and radiological improvements were recognized. The patient suspended the treatment for a month and the thrombus recurred. We present our case in order to show the effectiveness of immunosuppressive and anticoagulant therapies and rarely seen pulmonary thromboembolism in recurrent Behcet's disease.
心内血栓、肺动脉瘤、深静脉血栓形成和肺血栓栓塞是白塞病罕见的症状。一名20岁女性患者因咳嗽、发热、心悸和胸痛入院。胸部X线片显示肺门结构明显增大,因此进行了动态胸部计算机断层扫描(CT),结果观察到双侧肺动脉段呈瘤样扩张、慢性血栓伴肺不张以及与累及双下叶的肺栓塞相符的实变物质。据悉,该患者四年前被诊断为白塞病并接受秋水仙碱治疗,但未规律服药。患者住院治疗。经胸超声心动图检查发现右心室有一个大小为4.2×1.6cm的血栓。腹部CT检查诊断出髂静脉瘤样扩张以及多普勒超声检查发现深静脉血栓。在免疫抑制和抗凝治疗三个月后的复查中,发现一些临床和影像学方面的改善。患者中断治疗一个月后血栓复发。我们展示该病例是为了说明免疫抑制和抗凝治疗的有效性以及复发性白塞病中罕见的肺血栓栓塞情况。