Almutamaiz Ali H, Alshoabi Sultan A, Al Akhali Eman S, Hamid Abdullgabbar M, Gareeballah Awadia, Omer Awatif M
Department of Radiology, Al-Thawra Modern General Hospital, Sanaa, YEM.
Department of Radiology, Faculty of Medicine, Sana'a University, Sanaa, YEM.
Cureus. 2024 Aug 6;16(8):e66281. doi: 10.7759/cureus.66281. eCollection 2024 Aug.
Behçet's syndrome (BS) is a rare chronic multisystemic inflammatory disorder of unknown etiopathogenesis. BS is classified as a vasculitis of variable vessel size, which can manifest in both arterial and venous blood vessels. BS commonly presents with mucocutaneous and ocular manifestations. Superficial and deep vein thrombosis is present in 50% of patients, with atypical venous thrombosis affecting the inferior vena cava, superior vena cava, hepatic veins with Budd-Chiari syndrome, portal vein, cerebral sinuses, and right atrium and ventricle. Arterial manifestations include in situ thrombosis, pulmonary artery aneurysms, aneurysms of the abdominal aorta, and aneurysms of visceral and peripheral arteries. This article reports a new case of BS in a 28-year-old female patient who presented with severe dyspnea and hemoptysis. Echocardiography and cardiovascular magnetic resonance imaging led to the diagnosis of endomyocardial fibrosis and a large right ventricular thrombus with pulmonary embolism. Computed tomography angiography revealed multiple pulmonary aneurysms and emboli. Rare findings such as endomyocardial fibrosis and Budd-Chiari syndrome were noted. This case highlights the role of medical imaging modalities in diagnosing rare syndromes such as BS, as demonstrated in the current case.
白塞病(BS)是一种病因不明的罕见慢性多系统炎症性疾病。白塞病被归类为一种血管大小可变的血管炎,可在动脉和静脉血管中表现出来。白塞病通常表现为黏膜皮肤和眼部表现。50%的患者存在浅静脉和深静脉血栓形成,非典型静脉血栓形成可累及下腔静脉、上腔静脉、伴有布加综合征的肝静脉、门静脉、脑窦以及右心房和心室。动脉表现包括原位血栓形成、肺动脉瘤、腹主动脉瘤以及内脏和外周动脉瘤。本文报告了一名28岁女性白塞病新病例,该患者出现严重呼吸困难和咯血。超声心动图和心血管磁共振成像诊断为心内膜纤维化和一个伴有肺栓塞的巨大右心室血栓。计算机断层血管造影显示多发肺动脉瘤和栓子。注意到了心内膜纤维化和布加综合征等罕见表现。如本例所示,该病例突出了医学成像方式在诊断白塞病等罕见综合征中的作用。