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Complete heart block in a Caucasian woman with Behçet's disease: a case report.

Butt SU, McNeil J - J Med Case Rep (2016)

Bottom Line: She also had a history of recurrent diarrhea with a single episode of ocular inflammation in the recent past.She had no evidence of cardiac ischemia, and her autoimmune antibodies were within normal ranges.While mucocutaneous ulceration is indeed the most common manifestation of Behçet's disease, cardiovascular involvement tends to cause the most morbidity and mortality.

View Article: PubMed Central - PubMed

Affiliation: Department of Medicine, Lyell McEwin Hospital, Elizabeth Vale, SA, 5112, Australia. drsabeehurrehman@yahoo.com.

ABSTRACT

Background: Behçet's disease is a progressive diffuse inflammatory vasculitis characterized by recurrent oral and genital ulceration and ocular inflammation. Cardiac involvement is a rare but well-documented manifestation of Behçet's disease. Complete heart block in non-Caucasian populations has been reported previously; however, in this report, we describe a unique case of complete heart block in a Caucasian woman with Behçet's disease.

Case presentation: A 48-year-old Caucasian woman presented to our hospital with symptomatic complete heart block requiring a pacemaker implant on a background of recurrent oral and genital ulcers and oligoarthritis of 10 months' duration. She also had a history of recurrent diarrhea with a single episode of ocular inflammation in the recent past. She had no evidence of cardiac ischemia, and her autoimmune antibodies were within normal ranges. She was diagnosed with Behçet's disease according to international study group criteria and was commenced on prednisolone and sulfasalazine, to which she responded very well.

Conclusions: Cardiac complications should be considered when making a diagnosis of Behçet's disease, even in Caucasian patients. While mucocutaneous ulceration is indeed the most common manifestation of Behçet's disease, cardiovascular involvement tends to cause the most morbidity and mortality.

No MeSH data available.


Related in: MedlinePlus

a Complete atrioventricular block. b Normal sinus rhythm
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Fig1: a Complete atrioventricular block. b Normal sinus rhythm

Mentions: A 48-year-old Caucasian woman was admitted to our hospital with presyncope, nausea, and palpitations. An electrocardiogram (ECG) showed new, complete atrioventricular (AV) block (Fig. 1a). A permanent pacemaker was implanted, which resulted in resolution of her symptoms. Her serum troponin levels were within normal range. She subsequently developed intermittent watery diarrhea without blood or mucus and was passing 10–15 bowel movements per day. The patient reported having painful, recurrent oral and genital ulcers for the previous 10 months. She also had intermittent large joint swelling and tenderness during this period. Furthermore, she had had an episode of redness of her eyes 2 months before her first admission that had lasted for 2 weeks, consistent with uveitis. She had been admitted 3 weeks before her current presentation with chest pain due to pericarditis. An ECG at that time showed normal sinus rhythm (Fig. 1b), while an echocardiogram showed small pericardial effusion. At that time, tender swelling of her right knee joint was observed. Her physical examination also revealed numerous mucosal ulcers in her mouth and on the labia minora. Her past medical history included 40 pack-years smoking and a right lower limb deep venous thrombosis when she was pregnant with her second child.Fig. 1


Complete heart block in a Caucasian woman with Behçet's disease: a case report.

Butt SU, McNeil J - J Med Case Rep (2016)

a Complete atrioventricular block. b Normal sinus rhythm
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4837610&req=5

Fig1: a Complete atrioventricular block. b Normal sinus rhythm
Mentions: A 48-year-old Caucasian woman was admitted to our hospital with presyncope, nausea, and palpitations. An electrocardiogram (ECG) showed new, complete atrioventricular (AV) block (Fig. 1a). A permanent pacemaker was implanted, which resulted in resolution of her symptoms. Her serum troponin levels were within normal range. She subsequently developed intermittent watery diarrhea without blood or mucus and was passing 10–15 bowel movements per day. The patient reported having painful, recurrent oral and genital ulcers for the previous 10 months. She also had intermittent large joint swelling and tenderness during this period. Furthermore, she had had an episode of redness of her eyes 2 months before her first admission that had lasted for 2 weeks, consistent with uveitis. She had been admitted 3 weeks before her current presentation with chest pain due to pericarditis. An ECG at that time showed normal sinus rhythm (Fig. 1b), while an echocardiogram showed small pericardial effusion. At that time, tender swelling of her right knee joint was observed. Her physical examination also revealed numerous mucosal ulcers in her mouth and on the labia minora. Her past medical history included 40 pack-years smoking and a right lower limb deep venous thrombosis when she was pregnant with her second child.Fig. 1

Bottom Line: She also had a history of recurrent diarrhea with a single episode of ocular inflammation in the recent past.She had no evidence of cardiac ischemia, and her autoimmune antibodies were within normal ranges.While mucocutaneous ulceration is indeed the most common manifestation of Behçet's disease, cardiovascular involvement tends to cause the most morbidity and mortality.

View Article: PubMed Central - PubMed

Affiliation: Department of Medicine, Lyell McEwin Hospital, Elizabeth Vale, SA, 5112, Australia. drsabeehurrehman@yahoo.com.

ABSTRACT

Background: Behçet's disease is a progressive diffuse inflammatory vasculitis characterized by recurrent oral and genital ulceration and ocular inflammation. Cardiac involvement is a rare but well-documented manifestation of Behçet's disease. Complete heart block in non-Caucasian populations has been reported previously; however, in this report, we describe a unique case of complete heart block in a Caucasian woman with Behçet's disease.

Case presentation: A 48-year-old Caucasian woman presented to our hospital with symptomatic complete heart block requiring a pacemaker implant on a background of recurrent oral and genital ulcers and oligoarthritis of 10 months' duration. She also had a history of recurrent diarrhea with a single episode of ocular inflammation in the recent past. She had no evidence of cardiac ischemia, and her autoimmune antibodies were within normal ranges. She was diagnosed with Behçet's disease according to international study group criteria and was commenced on prednisolone and sulfasalazine, to which she responded very well.

Conclusions: Cardiac complications should be considered when making a diagnosis of Behçet's disease, even in Caucasian patients. While mucocutaneous ulceration is indeed the most common manifestation of Behçet's disease, cardiovascular involvement tends to cause the most morbidity and mortality.

No MeSH data available.


Related in: MedlinePlus