Miqdad Mohammed A, Mohamad Abdullah, Ali Fawaz, Kawari Mohammed, Alboainain Salha
Department of Internal Medicine, Dr. Sulaiman Al Habib Medical Group, Khobar, SAU.
Department of Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA.
Cureus. 2021 Oct 8;13(10):e18592. doi: 10.7759/cureus.18592. eCollection 2021 Oct.
Vascular complications of Behcet'sdisease, including intracardiac thrombus formation, are one of the significant causes of mortality and morbidity in this population. Similar to other vasculitic disorders, Behcet's disease is primarily treated with immunosuppressants. While the benefit of adding anticoagulants in Behcet's disease with thromboembolism remains debatable, some literature encourages its use with concomitant intracardiac thrombus. Herewith, we present the case of a young male who was diagnosed with bilateral pulmonary embolism in addition to right ventricle intracardiac thrombus upon his scheduled dose of infliximab infusion. He was managed by adding azathioprine to his regimen together with oral prednisolone and warfarin with a target international normalized ratio of 2-3. This case report addresses the importance and outcome of early identification of Behcet's disease's vascular complications and immediate initiation of anticoagulation accordingly.
白塞病的血管并发症,包括心内血栓形成,是该人群死亡和发病的重要原因之一。与其他血管炎疾病相似,白塞病主要采用免疫抑制剂治疗。虽然在伴有血栓栓塞的白塞病中添加抗凝剂的益处仍存在争议,但一些文献鼓励在伴有心内血栓的情况下使用抗凝剂。在此,我们报告一例年轻男性病例,该患者在预定剂量的英夫利昔单抗输注时,除右心室心内血栓外,还被诊断为双侧肺栓塞。通过在其治疗方案中添加硫唑嘌呤,同时使用口服泼尼松龙和华法林,使国际标准化比值目标维持在2 - 3,对其进行了治疗。本病例报告阐述了早期识别白塞病血管并发症并相应立即启动抗凝治疗的重要性和结果。