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Budd-chiari syndrome and renal arterial neurysms due to Behcet disease: a rare association.

Batur A, Dorum M, YĆ¼ksekkaya HA, Koc O - Pan Afr Med J (2015)

Bottom Line: Both rupture of arterial aneurysm and occlusion of suprahepatic veins, causing Budd-Chiari syndrome, are associated with a high mortality rate.Men and patients with a younger age of onset present with a more severe prognosis.In this case report, we describe a very rare cause of intrarenal arterial aneurysm's rupture with previous Budd-Chiari syndrome due to Behcet's disease and successful angiographic embolization of actively bleeding aneurysm.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Yuzuncuyil University Dursun Odabas Medical Center, Van, Turkey.

ABSTRACT
Behcet's disease is a multisystemic vasculitis of unknown etiology with a chronic relapsing course. Vasculitis in Behcet's disease with predominant vascular involvement is the only vasculitis that affects both arteries and veins of any size. Involvement of the renal artery and inferior vena cava is rare among the arteries and veins, respectively. When disease affect the veins, it is in the form of thrombosis. Arterial complications include aneurysms, stenosis and occlusions. Both rupture of arterial aneurysm and occlusion of suprahepatic veins, causing Budd-Chiari syndrome, are associated with a high mortality rate. Vascular involvement is more common in male patients than in female patients. Men and patients with a younger age of onset present with a more severe prognosis. In this case report, we describe a very rare cause of intrarenal arterial aneurysm's rupture with previous Budd-Chiari syndrome due to Behcet's disease and successful angiographic embolization of actively bleeding aneurysm.

No MeSH data available.


Related in: MedlinePlus

Axial (A) and 3D reconstructed coronal (B) images of the contrast-enhanced computed tomography demonstrates hematoma in the left retroperitoneal region associated with the kidney (short arrows) and signs of contrast leveling compatible with active bleeding (long arrows)
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Figure 0002: Axial (A) and 3D reconstructed coronal (B) images of the contrast-enhanced computed tomography demonstrates hematoma in the left retroperitoneal region associated with the kidney (short arrows) and signs of contrast leveling compatible with active bleeding (long arrows)

Mentions: The laboratory values; hemoglobine: 8.5 g/dL, platelets 228000/mm3, WBC 25.000/ul. Biochemistry and coagulation parameters were normal. Acute phase reactans were elevated (fibrinogen 533 mg/dl, erythrocyte sedimentation rate 24 mm/h, C reactive protein 29 mg/L, procalcitonine 1.064 ng/ml). In abdominal USG and tomography, in the left peritoneal region hematoma associated with kidney and signs of active bleeding was detected in the left kidney parenchyma (Figure 2). Renal angiography showed the left and right renal artery including multiple aneurysms (Figure 3). Celiac artery and superior mesenteric artery injections showed no pathology. Left inferior lobe segmental artery embolization was performed successfully (Figure 4). Which looked for the diagnosis of polyarteritis nodosa (PAN), anti-neutrophilic cytoplasmic antibody (ANCA) was positive. Steroid, cyclophosphamide and azothiopurine treatment has been started in addition to colchicine.


Budd-chiari syndrome and renal arterial neurysms due to Behcet disease: a rare association.

Batur A, Dorum M, YĆ¼ksekkaya HA, Koc O - Pan Afr Med J (2015)

Axial (A) and 3D reconstructed coronal (B) images of the contrast-enhanced computed tomography demonstrates hematoma in the left retroperitoneal region associated with the kidney (short arrows) and signs of contrast leveling compatible with active bleeding (long arrows)
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4594976&req=5

Figure 0002: Axial (A) and 3D reconstructed coronal (B) images of the contrast-enhanced computed tomography demonstrates hematoma in the left retroperitoneal region associated with the kidney (short arrows) and signs of contrast leveling compatible with active bleeding (long arrows)
Mentions: The laboratory values; hemoglobine: 8.5 g/dL, platelets 228000/mm3, WBC 25.000/ul. Biochemistry and coagulation parameters were normal. Acute phase reactans were elevated (fibrinogen 533 mg/dl, erythrocyte sedimentation rate 24 mm/h, C reactive protein 29 mg/L, procalcitonine 1.064 ng/ml). In abdominal USG and tomography, in the left peritoneal region hematoma associated with kidney and signs of active bleeding was detected in the left kidney parenchyma (Figure 2). Renal angiography showed the left and right renal artery including multiple aneurysms (Figure 3). Celiac artery and superior mesenteric artery injections showed no pathology. Left inferior lobe segmental artery embolization was performed successfully (Figure 4). Which looked for the diagnosis of polyarteritis nodosa (PAN), anti-neutrophilic cytoplasmic antibody (ANCA) was positive. Steroid, cyclophosphamide and azothiopurine treatment has been started in addition to colchicine.

Bottom Line: Both rupture of arterial aneurysm and occlusion of suprahepatic veins, causing Budd-Chiari syndrome, are associated with a high mortality rate.Men and patients with a younger age of onset present with a more severe prognosis.In this case report, we describe a very rare cause of intrarenal arterial aneurysm's rupture with previous Budd-Chiari syndrome due to Behcet's disease and successful angiographic embolization of actively bleeding aneurysm.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Yuzuncuyil University Dursun Odabas Medical Center, Van, Turkey.

ABSTRACT
Behcet's disease is a multisystemic vasculitis of unknown etiology with a chronic relapsing course. Vasculitis in Behcet's disease with predominant vascular involvement is the only vasculitis that affects both arteries and veins of any size. Involvement of the renal artery and inferior vena cava is rare among the arteries and veins, respectively. When disease affect the veins, it is in the form of thrombosis. Arterial complications include aneurysms, stenosis and occlusions. Both rupture of arterial aneurysm and occlusion of suprahepatic veins, causing Budd-Chiari syndrome, are associated with a high mortality rate. Vascular involvement is more common in male patients than in female patients. Men and patients with a younger age of onset present with a more severe prognosis. In this case report, we describe a very rare cause of intrarenal arterial aneurysm's rupture with previous Budd-Chiari syndrome due to Behcet's disease and successful angiographic embolization of actively bleeding aneurysm.

No MeSH data available.


Related in: MedlinePlus