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Superior vena cava syndrome revealing a Behçet's disease.

Sarr SA, Fall PD, Mboup MC, Dia K, Bodian M, Jobe M - Thromb J (2015)

Bottom Line: There were oral and genital ulcerations and erythematous skin lesions associated with a history of inflammatory recurrent arthralgia.Chest computed tomo-angiography showed cruoric internal jugular vein thrombosis extending to the superior vena cava with significant venous collateral circulation.There was no bleeding associated with anticoagulants use.

View Article: PubMed Central - PubMed

Affiliation: Service de cardiologie, CHU Aristide Le Dantec, Dakar, Sénégal.

ABSTRACT

Introduction: Behçet's disease (BD) is a rare vasculitis in sub-Saharan Africa. Vascular thrombosis, especially venous, is common in this condition and also constitutes a basic diagnostic criterion. Its affection of the superior vena cava is rather rare with only a few cases described in the literature.

Case report: A 42-year-old male patient was seen at consultation presenting with a pulsatile, warm and slightly painful right latero-cervical swelling extending to the supraclavicular fossa with the presence of collateral venous circulation for three weeks prior to presentation associated with a mild headache. There were oral and genital ulcerations and erythematous skin lesions associated with a history of inflammatory recurrent arthralgia. Chest computed tomo-angiography showed cruoric internal jugular vein thrombosis extending to the superior vena cava with significant venous collateral circulation. The patient was treated with prednisolone (1 mg/kg/day) and colchicine (2 mg/day), as well as anticoagulation with heparin and vitamin K antagonist (Acenocoumarol) with regular INR monitoring. Clinical evolution was favorable during hospitalization, with residual discrete right supraclavicular swelling. There was no bleeding associated with anticoagulants use.

Conclusion: The case stresses the importance of maintaining a high degree of suspicion for Behçet's disease in all cases of venous thrombosis.

No MeSH data available.


Related in: MedlinePlus

Edema and significant collateral venous circulation (left), scrotal ulcer in recovery phase (right).
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Fig1: Edema and significant collateral venous circulation (left), scrotal ulcer in recovery phase (right).

Mentions: On admission, clinical examination revealed a hyperthermia at 38.3°C but was hemodynamically stable. There was a warm, slightly painful, right latero-cervical swelling extending to the supraclavicular fossa. There was evident collateral venous circulation (Figure 1). The lung fields were clear, and there were no palpable lymph nodes and no signs of phlebitis. Further examination revealed healing scrotal ulcers and oral ulcerations as well as erythematous skin lesions.Figure 1


Superior vena cava syndrome revealing a Behçet's disease.

Sarr SA, Fall PD, Mboup MC, Dia K, Bodian M, Jobe M - Thromb J (2015)

Edema and significant collateral venous circulation (left), scrotal ulcer in recovery phase (right).
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4321387&req=5

Fig1: Edema and significant collateral venous circulation (left), scrotal ulcer in recovery phase (right).
Mentions: On admission, clinical examination revealed a hyperthermia at 38.3°C but was hemodynamically stable. There was a warm, slightly painful, right latero-cervical swelling extending to the supraclavicular fossa. There was evident collateral venous circulation (Figure 1). The lung fields were clear, and there were no palpable lymph nodes and no signs of phlebitis. Further examination revealed healing scrotal ulcers and oral ulcerations as well as erythematous skin lesions.Figure 1

Bottom Line: There were oral and genital ulcerations and erythematous skin lesions associated with a history of inflammatory recurrent arthralgia.Chest computed tomo-angiography showed cruoric internal jugular vein thrombosis extending to the superior vena cava with significant venous collateral circulation.There was no bleeding associated with anticoagulants use.

View Article: PubMed Central - PubMed

Affiliation: Service de cardiologie, CHU Aristide Le Dantec, Dakar, Sénégal.

ABSTRACT

Introduction: Behçet's disease (BD) is a rare vasculitis in sub-Saharan Africa. Vascular thrombosis, especially venous, is common in this condition and also constitutes a basic diagnostic criterion. Its affection of the superior vena cava is rather rare with only a few cases described in the literature.

Case report: A 42-year-old male patient was seen at consultation presenting with a pulsatile, warm and slightly painful right latero-cervical swelling extending to the supraclavicular fossa with the presence of collateral venous circulation for three weeks prior to presentation associated with a mild headache. There were oral and genital ulcerations and erythematous skin lesions associated with a history of inflammatory recurrent arthralgia. Chest computed tomo-angiography showed cruoric internal jugular vein thrombosis extending to the superior vena cava with significant venous collateral circulation. The patient was treated with prednisolone (1 mg/kg/day) and colchicine (2 mg/day), as well as anticoagulation with heparin and vitamin K antagonist (Acenocoumarol) with regular INR monitoring. Clinical evolution was favorable during hospitalization, with residual discrete right supraclavicular swelling. There was no bleeding associated with anticoagulants use.

Conclusion: The case stresses the importance of maintaining a high degree of suspicion for Behçet's disease in all cases of venous thrombosis.

No MeSH data available.


Related in: MedlinePlus