Management of Anesthesia in a Pregnant with Behçet’s Disease

Öz

Behçet’s disease was described by Dr. Hulusi Behçet in 1937. Behçet’s disease is an inflammatory multisystem disease including recurrent oral and genital ulcers, eye and skin symptoms, joint, vein and nervous system involvement. Especially the scar tissue formed due to recurrent oral ulcers causes difficult intubation and ventilation. Also the drugs used for treatment may cause adverse effects on many organs. It has great importance for anesthesia choice due to multiple organ involvement. Our case was a 38-year old woman, who has been diagnosed as Behçet’s, caesarean section was planned at 38 weeks of gestation. Behçet’s disease and pregnancy are both important for the anesthesia management. It was planned as a general anesthesia for the patient because it was not thought to be a difficult airway management. In this case report the general anesthesia management of the patient with Behçet’s Disease was discussed.

Anahtar Kelimeler

• Behçet’s disease,pregnancy,anesthesia

Behçet Hastalığı Olan Gebede Anestezi Yönetimi

Öz

Behçet hastalığı Dr. Hulusi Behçet tarafından 1937’de tanımlanmıştır. Behçet hastalığı tekrarlayan oral ve genital ülserlerin görüldüğü, göz, deri, eklem, damar, sinir sistemi tutulumu gösteren multisistemik iltihabi bir hastalıktır. Özellikle tekrarlayan oral ülserlere bağlı oluşan skar dokusu entübasyon ve ventilasyonu zorlaştırmaktadır. Birçok organ tutulumu nedeni ile anestezi seçimi önem arz eder. Ayrıca tedavide kullanılan ilaçlar birçok organ üzerinde yan etki oluşturabilir. Olgu, 38 yaşında, 38 haftalık gebeliği olan ve sezaryen planlanan Behçet hastasıydı. Hem Behçet hastalığı hem de gebelik, anestezi yönetimi açısından önemlidir. Hastada öncelikli olarak zor havayolu düşünülmediği için genel anestezi planlandı. Bu olgu sunumunda Behçet hastası olan bir hastada genel anestezi yönetimi tartışılmıştır.

Anahtar Kelimeler

• Behçet hastalığı,gebelik,anestezi

Kaynakça

1. 1. Behçet H. Uber rezideverende aphtose, duch ein virüs verursachte geschwure am mund, am auge und den genitalien. Derm Wochenschr 1937;36:1152–7.
2. 2. Türköz A, Toprak IH, Köroğlu A, But AK, Toprak Hİ, Ersoy ME. Anesthetic management and endovascular stent grafting of abdominal aortic aneurysm in a patient with Behçet’s disease. J Cardiothorac Vasc Anesth 2002;16:468–70.
3. 3. Idil A, Gürler A, Boyvat A, Caliskan D, Ozdemir O, Isik A, et al. The prevalence of Behçet’s disease above the age of 10 years. The results of a pilot study conducted at the Park Primary Health Care Center in Ankara, Turkey. Ophthalmic Epidemiol 2002;9:325–31.
4. 4. Özbalkan Z, Bilgen ŞA. Behçet’s disease. Hacettepe Med J 2006;37:14–20.
5. 5. Turner ME. Anaesthetic difficulties associated with Behçet’s syndrome. Case report. Br J Anaesth 1972;44:100–2.
6. 6. Goz M, Cakir O, Eren MN. Behçet’s Syndrome: Is Ligation an Alternative Treatment? Vascular 2007;15(1):46–8.
7. 7. Noel N, Wechsler B, Nizard J, Costedoat CN, Boutindu LT, Dommergues M, et al. Behçet’s disease and pregnancy. Arthritis Rheum 2013;65:2450–6.
8. 8. Bang D, Chun YS, Haam IB, Lee E-S, Lee S. The influence of pregnancy on Behçet’s Disease. Yonsei Med J 2007;38:437–43.

9. 9. Marsal S, Falga C, Simeon CP, Vılardell M, Bosch JA. Behçet’s Disease And Pregnancy Relationship Study. Br J Rheumatol 1997;36:234–8.
10. 10. Salihoglu Z, Dikmen Y, Demiroluk S, Hamzaoglu I, Paksoy M. Oral aphthous ulcers after difficult intubation in a patient with Behçet’s disease. Anaesthesia 2002;57:620–1.
11. 11. Bhardwaj M, Singh K, Taxak S. Oral Scarring in Behçet’s Disease An Airway Concern. J Anesthe Clinic Res 2012;3:183.
12. 12. Berkow R. The Merc Manuel Teşhis ve Tedavi El Kitabı. Çeviri. Pekus M, İstanbul, Merc Yay 1985:905–6.
13. 13. Ertürk E, Şenel AC, Koşucu M, Kaya F, Erciyes N. Behçet Hastalığında Anestezi Uygulaması –Rejyonal mi, genel mi? Türk Anest Rean Der Derg 2009;37(2):114–7.
14. 14. Porcu P, Chavanon O, Bertrand B, Costache V, Carley H, Bach V, et al. Giant aneurysm of the proximal segment of the left anterior descending artery in a patient with Behçet’s disease-a combined approach. Canadian J Cardiol 2008;24(10):73–4.
15. 15. Özcan A, Balcı C, Aksoy ŞM. Behçet hastasında anestezi yönetimi. Medeniyet Medical Journal. 2015;30(1):60–2.