MiscellaneousResolution of Behçet's Syndrome Associated Pulmonary Arterial Aneurysms with Infliximab
Section snippets
Methods
The patient described in the case report was referred to the Behçet's clinic at Hammersmith Hospital, London, where he underwent further investigation and treatment. Information, including operation notes and histopathology, was obtained from the referring hospital. Clinical and laboratory information was collected from his medical records. We reviewed the English language medical literature using the PubMed and Medline search terms “Behçet” and “pulmonary arterial aneurysms” together with
Results
A 43-year-old unemployed British white man presented to his local hospital with an enlarging right-sided neck lump and a pulsatile “barking” sound in his right ear. Ultrasonography showed a saccular aneurysm of the right common carotid artery. The carotid artery was resected and continuity was restored with autologous great saphenous vein interposition graft. On histology, the adventitia of the excised artery showed inflammation around the vasa vasorum and extravasation of red cells (Fig. 1).
Discussion
Vascular involvement is common in BS, having been reported in 14% of patients in Turkey (3) and 25% in the UK (4, 5). It is more common in men than in women. In our own experience we have found vascular complications in 21% of men and 14% of women, satisfying the International Study Group criteria (2). We present here a case of aggressive BS with multiple aneurysms and thromboses. The association of deep vein thromboses with pulmonary arterial aneurysms, as seen in our patient, has been
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2016, Autoimmunity ReviewsPulmonary artery aneurysms in Behçet's disease treated with anti-TNFα: A case series and review of the literature
2016, Autoimmunity ReviewsCitation Excerpt :All five patients responded to TNFα-inhibitors. Two patients showed resolution of PAA after failing CYC [11–15]. Table 1 summarises these reported cases with Case 1 and Case 2.
Pulmonary artery involvement in Behçet's syndrome: Effects of anti-Tnf treatment
2015, Seminars in Arthritis and RheumatismCitation Excerpt :Our initial experience with infliximab in 3 patients with hepatic vein thrombosis (Budd–Chiari syndrome) was not promising in that 2 patients had died and the third had developed cranial sinus thrombosis during treatment [9]. On the other hand, both infliximab and adalimumab have been found to be effective in case records of PAI when used after immunosuppressives or given as the initial therapy [10,11]. In this survey we present our experience with anti-TNF agents in BS patients with PAI who received these agents following an inadequate response to conventional immunosuppressives.
DOH was in receipt of funding from the British Heart Foundation. The study was made possible by funding from the National Institute of Research Comprehensive Biomedical Research Centre at Imperial College Healthcare NHS Trust.
The authors have no conflicts of interest to disclose.