Behçet Hastalığında Kardiyovasküler Tutulum

Yıl 2014, Cilt: 15 Sayı: 2, 218 - 225, 01.08.2014

Önder Akci Alaettin Avşar

Öz

Behcet's Disease is a chronic inflammatory with multiorgan involvements that it develope relapses. It appear more frequently at the 3rd and 4th decades and it show regional differences for sexuality. This disease is characterized with recurrent oral and genital ulcers, skin signs and uveitis. Behcet’s Disease is a major cause of morbidity and mortality. In some patients exist only skin and mucosa lesions and some are serious diseased with threatening involvements gastrointestinal system and pulmonary artery. The risk of cardiovascular mortality is increased in Behcet’s Disease according to normal individuals

Anahtar Kelimeler

Behçet's disease; clinical manifestations; cardiovascular disease

Behçet Hastalığında Kardiyovasküler Tutulum

Öz

Behçet Hastalığı, nükslerle seyreden, çoklu organ tutulumu gösteren, kronik enflamatuvar bir hastalıktır. Genellikle 3. ve 4. dekatlarda görülür ve cinsiyet tercihi bölgesel farklılık gösterir. Hastalık, tekrarlayan ağız ve genital bölge ülserleri, deri bulguları ve üveit ile karakterizedir. Behçet hastalığı önemli bir morbidite ve mortalite nedenidir. Bazı hastalarda, sadece deri ve mukoza lezyonları gözlenirken, bazılarında ise yaşamı tehdit edici merkezi sinir sistemi (MSS) ve gastrointestinal sistem (GIS) tutulumları, pulmoner arter anevrizması görülebilmektedir. Behçet Hastalığı olgularında, normal bireylere göre kardiyovasküler mortalite riski artmıştır

Anahtar Kelimeler

Behçet hastalığı; klinik belirtiler; kardiyovasküler hastalıklar

Kaynakça

• Behçet H, Matteson EL. On relapsing, aphthous ulcers of the mouth, eye and genitalia caused by a virus. 1937. Clin Exp Rheumatol 2010;28(4):2-5.
• Saadoun D, Wechsler B. Behçet's disease. Orphanet J Rare Dis 2012;7:20.
• Saylan T, Mat C, Fresko I, Melikoğlu M. Behcet’s disease in The Middle East. Clin Dermatol 1999;17(2):209-22.
• Verity DH, Marr JE, Ohno S, Wallace GR, Standford MR. Behçet’s disease, the Silk Road and HLAB51:historical and geographical perspectives. Tissue Antigens 1999;54(3):213–20.
• Zoubloulis CC. Epidemiology of Adamantiades- Behçet's disease. Ann Med Interne 1999;150(6):488
• Yurdakul S, Tuzuner N, Yurdakul I, Hamuryudan V, Yazici H. Gastrointestinal involvement in Behcet's syndrome: a controlled study. Ann Rheum Dis 1996;55(3):208-10.
• Poon W, Verity DH, Larkin GL, Graham EM, Stanford MR. Behcet's disease in patients of west African and Afro-Caribbean origin. Br J Ophthalmol 2003;87(7):876-8.
• Direskeneli H, Eksioglu-Demiralp E, Kibaroglu A, Yavuz S, Ergun T, Akoglu T. Oligoclonal T cell expansions in patients with Behcet's disease. Clin Exp Immunol 1999;117(1):166-70.
• Direskeneli H. Behcet's disease: infectious aetiology, new autoantigens, and HLA-B51. Ann Rheum Dis 2001;60(11):996-1002.
• Direskeneli, Keser G, D'Cruz D, et al. Anti- endothelial cell antibodies, endothelial proliferation and von willebrand factor antigen in Behcet's disease. Clin Rheumatol 1995;14(1):55-61.
• Tokay S, Direskeneli H, Yurdakul S, Akoglu H. Anticardiolipin antibodies in Behcet's disease: A reassessment. Rheumatology 2001;40(2):192-5.
• Criteria for diagnosis of Behcet's disease. International Study Group for Behcet's Disease. Lancet 1990:335(8697);1078-80.
• Gündüz O. Histopathological evaluation of Behçet's disease and identification of new skin lesions. Patholog Res Int 2012;2012:209316.
• Wechsler B , Piette J C. Behçet's disease. BMJ 1992;304(6836):1199–200.
• Hatemi G, Bahar H, Uysal S, et al. The pustular skin lesions in Behçet's syndrome are not sterile. Ann Rheum Dis 2004;63(11):1450–2. Alpsoy
• Mucocutaneous lesions of Behcet's disease. Yonsei Zouboulis Med J 2007;48(4):573-85. CC, Ehrlich GE.
• Özbalkan Z, Apras Bilgen S. Behcet hastalığı der- leme. Hacettepe Tıp Dergisi 2006;37(1):14-20.
• Kitaichi N, Miyazaki A, Stanford MR. Ocular features of Behçet's disease: an international collaborative 2007;91(12):1579–82. Br J Ophthalmol
• Tugal-Tutkun I, Onal S, Altan-Yaycioglu R, Huseyin Altunbas H, Urgancioglu M. Uveitis in Behçet disease: an analysis of 880 patients. Am J Ophthalmol 2004;138(3):373-80.
• Akman-Demir G, Serdaroglu P, Tasçi B. Clinical patterns of neurological involvement in Behçet's disease: evaluation of 200 patients. The Neuro- Behçet Study Group. Brain 1999;122(11):2171-82.
• Adamantiades-Behcet's Neurosurg Psychiatry 2006;77(8):956-7. J syndrome. Neurol
• Yurdakul S, Tüzüner N, Yurdakul I, Hamuryudan V, Yazici H. Gastrointestinal involvement in Behçet's syndrome: a controlled study. Ann Rheum Dis 1996;55(3):208–10.
• Kaklamani VG, Vaiopoulos G, Kaklamanis PG. Semin Arthritis Rheum 1998;27(4):197-217.
• Sarica-Kucukoglu R, Akdag-Kose A, Kayabal I M. Vascular involvement in Behçet's disease: a retrospective analysis of 2319 cases. Int J Dermatol 2006;45(8):919-21.
• Bayraktar Y, Balkanci F, Bayraktar M, Calguneri M. Budd-Chiari syndrome: a common complication of Behcet's disease. Am J Gastroenterol 1997;92(5):858
• Ma WG, Zheng J, Zhu JM, Liu YM, Li M, Sun LZ. Aortic regurgitation caused by Behçet's disease: surgical experience during an 11-year period. J Card Surg 2012;27(1):3944.
• Lee CW, Lee J, Lee WK, et al. Aortic valve involvementin Behcet’s disease. A clinical study of 9 patients. Korean J Intern Med 2002;17(1):51-6.
• Jeong DS, Kim KH, Kim JS, et al. Long-term experience of surgical treatment for aortic regurgitation attributable to Behcet’s disease. Ann Thorac Surg 2009;87(6):1775-82.
• Suzuki A, Amano J, Tanaka H, et al. Surgical consideration of aortitis involving the aortic root. Circulation 1989;80(3 Pt 1):I222-32.
• Uzun O, Akpolat T, Erkan L. Pulmonary vasculitis in behcet disease: a cumulative analysis. Chest 2005;127(6):2243-53.
• Seyahi E, Baskurt M, Melikoglu M, et al. The estimated pulmonary artery pressure can be elevated in syndrome. 2011;105(11):1739-47. Respir Med
• Gurgun C, Ercan E, Ceyhan C, et al. Cardiovascular involvement in Behcet’s disease. Jpn Heart J 2002;43(4):389-98.
• Huycke EC, Robinowitz M, Cohen IS, et al. Granulomatous endocarditis with systemic embolism in Behcet’s disease. Ann Intern Med 1985;102(6):791
• Le Thi Huong D, Wechsler B, Papo T, et al. Arterial lesions in Behcet’s disease. A study in 25 patients. J Rheumatol 1995;22(11):2103-13.
• Huong DL, Wechsler B, Papo T, et al. Endomyocardial fibrosis in Behcet’s disease. Ann Rheum Dis 1997;56(3):205-8.
• Vanhaleweyk G, el-Ramahi KM, Hazmi M, et al. Right atrial, right ventricular and left ventricular thrombi in (incomplete) Behcet’s disease. Eur Heart J 1990;11(10):957-9.
• Rolland JM, Bical O, Laradi A, et al. False aneurysm of the left ventricle and coronary aneurysms in Behcet disease. Arch Mal Coeur Vaiss 1993;86(9):1383-5.
• Gürgün C, Ercan E, Ceyhan C, et al. Cardiovascular involvement in Behcet's disease. Jpn Heart J 2002;43(4):389-98.
• Geri G, Wechsler B, Thi Huong du L, et al. Spectrum of cardiac lesions in behçet disease: a series of 52 patients and review of the literature. Medicine (Baltimore) 2012;91(1):25-34.
• Koc F, Koc S, Yuksek J, et al. Is diastolic dysfunction electrocardiographic parameters in Behçet's disease? Acta Cardiol 2011;66(5):607-12. with atrial
• Serdaroglu P. Behcet’s disease and the nervous system. J Neurol 1998;245(4):197-205.
• Aksoyek S, Aytemir K, Ozer N, Ozcebe O, Oto A. Assessment of autonomic nervous system function in patients with Behcet’s disease by spectral analysis of heart rate variability. J Auton Nerv Syst 1999;77(2- 3):190-4.
• Aytemir K, Ozer N, Aksoyek S, Ozcebe O, Kabakcı G, Oto A. Increased QT dispersion in the absence of QT prolongation in patients with Behçet’s disease and ventricular arrhythmias. Int J Cardiol 1998;67(2):171
• Morshedi-Meibodi A, Larson MG, Levy D, O’Donnell CJ, Vasan RS. Heart rate recovery after treadmill exercise testing and risk of cardiovascular disease events (The Framingham Heart Study). Am J Cardiol 2002;90(8):848-52.
• Marshall SE. Behcet's disease. Best Pract Res Clin Rheumatol 2004;18(3):291-311.
• Arca E, Gür AR. Behçet hastalıgı. T Klin Tıp Bilimle- ri 2003;23(3):261-8.
• Akpolat I, Akpolat T, Danaci M, Bariş YS, Kaya N, Kandemir B. Behçet’s disease and amyloidosis. Review of the literature. Scand J Rheumatol 1997;26(6):477-9.
• Tuzun H, Seyahi E, Arslan C, Hamuryudan V, Besirli K, Yazici nonpulmonary large arterial disease in patients with Behçet disease. J Vasc Surg 2012;55(1):157-63.
• Alpsoy E. Behçet hastalıgında tedavi. Türk Derma- toloji Dergisi 2007;1(1):1-7.
• Yazici H, Pazarli H, Barnes CG. A controlled trial of azothioprine in Behçet’s syndome. THA New England Journal of Medicine 1990;322(5):281-5.
• Kleiner RC. Frosted branch angiitis: clinical syndrome or clinical sign? Retina 1997;17(5):370-1.
• Cantasdemir M, Kantarci F, Mihmanli I, et al. Emergency endovascular management of pulmonary artery aneurysms in Behcet’s disease: report of two cases and review of the literature. Cardiovasc Intervent Radiol 2002;25(6):533–7.
• Schiff S, Moffatt R, Mandel WJ, Rubin SA. Acute myocardial infarction and recurrent ventricular arrhythmias in Behcet’s syndrome. Am Heart J 1982;103(3):438-40.