Limits...
A case of Behçet's syndrome with supeior vena cava syndrome.

Han DS, Kim JB, Lee OY, Sohn JH, Park KN, Park CK - Korean J. Intern. Med. (1998)

Bottom Line: There were multiple thrombosis of the superior vena cava, innominate and subclavian veins.This patient also had a solitary cecal ulcer with an ileocecal fistula and downhill varix.The chest CT, veno-cavography, pulmonary angiography and colon study were taken and follow-up was performed.

View Article: PubMed Central - PubMed

Affiliation: Department of Internal Medicine, Radiology Hanyang University Kuri Hospital, Korea.

ABSTRACT
Behçet's syndrome is a multi-systemic and chronic disorder that affects many organs. It has been suggested that the diagnosis was based on the presence of the 'major' and 'minor' clinical criteria. When thromobophlebitis, arthritis, central nervous system or gastrointestinal lesions are also present. Behçet's syndrome will be thought to be present in the appropriate geographic area. We report a case of superior vena cava syndrome caused by Behçet's disease in a 40-year-old man with recurrent oral aphthous ulcers and skin rashes on the anterior chest wall. There were multiple thrombosis of the superior vena cava, innominate and subclavian veins. This patient also had a solitary cecal ulcer with an ileocecal fistula and downhill varix. The chest CT, veno-cavography, pulmonary angiography and colon study were taken and follow-up was performed.

Show MeSH

Related in: MedlinePlus

Follow-up CT after 3 months from initial CT scan shows newly developed consolidation in the left posterior basal segment(long arrow). The pleural effusion in the right hemithorax is decreased.
© Copyright Policy
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC4531936&req=5

f3-kjim-13-1-72-14: Follow-up CT after 3 months from initial CT scan shows newly developed consolidation in the left posterior basal segment(long arrow). The pleural effusion in the right hemithorax is decreased.

Mentions: In February 1996, he was admitted to the hospital. In the ensuing twelve weeks, he felt less plethoric and had mildly collapsed neck vein engorgement. On examination, he had several painful aphthous oral ulcers, 2–8mm in diameter, with a central yellowish necrotic base on the tongue. Neck vein engorgement was somewhat decreased. He had painful swelling of the right knee joint. The pathergy skin test was negative. Hematological and biochemical tests were as follows: white blood cell count was 7,200/mm3, hemoglobin 12.6g/dL, platelet 320,000/mm3. Erythrocyte sedimentation rate was 39mm/hr and C-reactive protein was negative. The prothrombin time and activated partial thromboplastin time were normal. The rheumatoid factors, antinuclear antibody, antinuclear DNA, anticardiolipin antibody, lupus anticoagulant, antiphospholipid antibody and antineutophil cytoplasmic autoantibody were negative. There was no proteinuria and hematuria. Protein C, protein S, factor VIII, fibrinogen and antithrombin III were all normal. Follow-up CT scan demonstrated decreased pleural effusion, but newly developed consolidation at the left lower lobe territory, 3×1.5×3cm size in diameter, suggested focal pulmonary infarction(Fig. 3). SVC obstruction and many collateral vessels still persisted. Venocavogram was obtained after injection of 40ml contrast materials(Ultravist, Scherring, Germany) through both basilic veins. The venacavogram showed complete occlusion of the SVC, right subclavian vein and partial occlusion of the left subclavian vein. Subsequent pulmonary angiography was normal. The colon study and colonoscopy revealed solitary cecal ulcer with an irregular mucosal change of the ileocecal area and ileocecal fistula(Fig. 5).


A case of Behçet's syndrome with supeior vena cava syndrome.

Han DS, Kim JB, Lee OY, Sohn JH, Park KN, Park CK - Korean J. Intern. Med. (1998)

Follow-up CT after 3 months from initial CT scan shows newly developed consolidation in the left posterior basal segment(long arrow). The pleural effusion in the right hemithorax is decreased.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4531936&req=5

f3-kjim-13-1-72-14: Follow-up CT after 3 months from initial CT scan shows newly developed consolidation in the left posterior basal segment(long arrow). The pleural effusion in the right hemithorax is decreased.
Mentions: In February 1996, he was admitted to the hospital. In the ensuing twelve weeks, he felt less plethoric and had mildly collapsed neck vein engorgement. On examination, he had several painful aphthous oral ulcers, 2–8mm in diameter, with a central yellowish necrotic base on the tongue. Neck vein engorgement was somewhat decreased. He had painful swelling of the right knee joint. The pathergy skin test was negative. Hematological and biochemical tests were as follows: white blood cell count was 7,200/mm3, hemoglobin 12.6g/dL, platelet 320,000/mm3. Erythrocyte sedimentation rate was 39mm/hr and C-reactive protein was negative. The prothrombin time and activated partial thromboplastin time were normal. The rheumatoid factors, antinuclear antibody, antinuclear DNA, anticardiolipin antibody, lupus anticoagulant, antiphospholipid antibody and antineutophil cytoplasmic autoantibody were negative. There was no proteinuria and hematuria. Protein C, protein S, factor VIII, fibrinogen and antithrombin III were all normal. Follow-up CT scan demonstrated decreased pleural effusion, but newly developed consolidation at the left lower lobe territory, 3×1.5×3cm size in diameter, suggested focal pulmonary infarction(Fig. 3). SVC obstruction and many collateral vessels still persisted. Venocavogram was obtained after injection of 40ml contrast materials(Ultravist, Scherring, Germany) through both basilic veins. The venacavogram showed complete occlusion of the SVC, right subclavian vein and partial occlusion of the left subclavian vein. Subsequent pulmonary angiography was normal. The colon study and colonoscopy revealed solitary cecal ulcer with an irregular mucosal change of the ileocecal area and ileocecal fistula(Fig. 5).

Bottom Line: There were multiple thrombosis of the superior vena cava, innominate and subclavian veins.This patient also had a solitary cecal ulcer with an ileocecal fistula and downhill varix.The chest CT, veno-cavography, pulmonary angiography and colon study were taken and follow-up was performed.

View Article: PubMed Central - PubMed

Affiliation: Department of Internal Medicine, Radiology Hanyang University Kuri Hospital, Korea.

ABSTRACT
Behçet's syndrome is a multi-systemic and chronic disorder that affects many organs. It has been suggested that the diagnosis was based on the presence of the 'major' and 'minor' clinical criteria. When thromobophlebitis, arthritis, central nervous system or gastrointestinal lesions are also present. Behçet's syndrome will be thought to be present in the appropriate geographic area. We report a case of superior vena cava syndrome caused by Behçet's disease in a 40-year-old man with recurrent oral aphthous ulcers and skin rashes on the anterior chest wall. There were multiple thrombosis of the superior vena cava, innominate and subclavian veins. This patient also had a solitary cecal ulcer with an ileocecal fistula and downhill varix. The chest CT, veno-cavography, pulmonary angiography and colon study were taken and follow-up was performed.

Show MeSH
Related in: MedlinePlus