Division of General Internal Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Japan.
Department of Rheumatology and Clinical Immunology, Kobe University Hospital, Japan.
Intern Med. 2023 Jul 1;62(13):2009-2012. doi: 10.2169/internalmedicine.0209-22. Epub 2022 Nov 16.
A 38-year-old man with deep vein thrombosis associated with Behçet's disease (BD) was admitted to our hospital due to worsening symptoms despite the initiation of direct oral anticoagulants (DOACs). Administration of oral prednisolone and an intravenous anti-tumor necrosis factor-alpha (TNF-α) monoclonal antibody dramatically improved his symptoms. In addition, he was incidentally diagnosed with autosomal dominant polycystic kidney disease, which increases the risk of aortic aneurysms. BD also increases the risk of aortic aneurysms. This case suggests that immunosuppressive treatment is effective in patients with inflammation-related DOAC-refractory venous thrombosis who also suffer from BD.
一位 38 岁男性因与贝赫切特病（BD）相关的深静脉血栓形成而入院，尽管已开始使用直接口服抗凝剂（DOACs），但症状仍在恶化。给予口服泼尼松龙和静脉注射抗肿瘤坏死因子-α（TNF-α）单克隆抗体后，他的症状显著改善。此外，他还意外被诊断为常染色体显性多囊肾病，这增加了他患主动脉瘤的风险。BD 也会增加主动脉瘤的风险。本病例提示，对于炎症相关 DOAC 难治性静脉血栓形成且同时患有 BD 的患者，免疫抑制治疗是有效的。
