Rheumatology International

, Volume 26, Issue 8, pp 758–759

Deep venous thrombosis in a patient with Behçet’s disease and homozygous prothrombin (factor II) G20210A mutation on oral contraceptive pills

Case report


Behçet’s disease (BD) is a multisystemic disease of unknown aetiology characterized by chronic relapsing oral aphthous lesions, genital ulcers, uveitis, and vasculopathy of both arteries and veins of all sizes. We present the case of a female patient, with BD on oral contraceptive pills, who sustained deep venous thrombosis of the long saphenous vein. The patient was found to be a carrier of a homozygous mutation of the prothrombin (factor II) G20210A gene. Our case suggests that a thrombophilia work-up may be warranted in BD patients, especially young women before they are prescribed oral contraceptives.


Behcet’s disesase Vasculopathy Prothrombin 


  1. 1.
    Lie JT (1992) Vascular involvement in Behcet’s disease: arterial and venous and vessels of all sizes. J Rheumatol 19(3):341–343PubMedGoogle Scholar
  2. 2.
    Salvarani C, Calamia K, Silingardi M, Ghirarduzzi A, Olivieri I (2000) Thrombosis associated with the prothrombin G→A20210 mutation in Behcet’s disease. J Rheumatol 27(2):515–516PubMedGoogle Scholar
  3. 3.
    Leiba M, Sidi Y, Gur H, Leiba A, Ehrenfeld M (2001) Behcet’s disease and thrombophilia. Ann Rheum Dis 60(12):1081–1085PubMedCrossRefGoogle Scholar
  4. 4.
    Martinelli I, Sacchi E, Landi G, Taioli E, Duca F, Mannucci PM (1998) High risk of cerebral-vein thrombosis in carriers of a prothrombin-gene mutation and in users of oral contraceptives. N Engl J Med 338(25):1793–1797PubMedCrossRefGoogle Scholar
  5. 5.
    Uthman I, Kassak K, Sanjakdar R, Mendelek V, Masri AF, Nasr FW (1997) Letter from Lebanon. Br J Rheumatol 36(7):806–807PubMedCrossRefGoogle Scholar
  6. 6.
    Bertina RM (1998) The prothrombin 20210 G to A variation and thrombosis. Curr Opin Hematol 5(5):339–342PubMedCrossRefGoogle Scholar
  7. 7.
    Akar N, Misirlioglu M, Akar E, Avcu F, Yalcin A, Sozuoz A (1998) Prothrombin gene 20210 G-A mutation in the Turkish population. Am J Hematol 58(3):249PubMedCrossRefGoogle Scholar
  8. 8.
    Taher A, Khalil I, Abou-Merhi R, Shamseddine A, Bazarbachi A (2003) High prevalence of prothrombin G20210A mutation among patients with deep venous thrombosis in Lebanon. Thromb Haemost 89(5):945–946PubMedGoogle Scholar
  9. 9.
    Howard TE, Marusa M, Channell C, Duncan A (1997) A patient homozygous for a mutation in the prothrombin gene 3’-untranslated region associated with massive thrombosis. Blood Coagul Fibrinolysis 8(5):316–319PubMedCrossRefGoogle Scholar
  10. 10.
    Vayá A, Villa P, Mira Y, Ferrando F, Aznar J, Estellés A, et al (2000) Intracardiac thrombosis in a case of Behcet’s disease associated with a prothrombin 20210G-A mutation. Haematologica 85(4):425–428PubMedGoogle Scholar
  11. 11.
    Tursen U, Kaya TI, Eskandari G, Gunduz O, Yazar M, Ikizoglu G et al (2001) Association of factor V Leiden and prothrombin gene mutation with Behçet’s disease. Arch Dermatol Res 293(10):537–539PubMedCrossRefGoogle Scholar
  12. 12.
    Espinosa G, Font J, Tàssies D, Vidaller A, Deulofeu R, López-Soto A, et al (2002) Vascular involvement in Behçet’s disease: Relation with thrombophilic factors, coagulation activation, and thrombomodulin. Am J Med 112(1):37–43PubMedCrossRefGoogle Scholar
  13. 13.
    Silingardi M, Salvarani C, Boiardi L, Accardo P, Iori I, Iorio A et al (2004) Factor V Leiden and Prothrombin Gene G20210A mutations in Italian patients with Behçet’s disease and deep vein thrombosis. Arthritis Care Res 51(2):177–183PubMedCrossRefGoogle Scholar
  14. 14.
    Gul A, Aslantas AB, Tekinay T, Konice M, Ozcelik T (1999) Procoagulant mutations and venous thrombosis in Behcet’s disease. Rheumatol (Oxford) 38(12):1298–1299CrossRefGoogle Scholar
  15. 15.
    Toydemir PB, Elhan AH, Tukun A, Toydemir R, Gurler A, Tuzuner A et al (2000) Effects of factor V gene G1691A, methylenetetrahydrofolate reductase gene C677T, and prothrombin gene G20210A mutations on deep venous thrombogenesis in Behcet’s disease. J Rheumatol 27(12):2849–2854PubMedGoogle Scholar
  16. 16.
    Taher A, Khalil I, Shamseddine A, El-Ahdab F, Bazarbachi A (2001) High prevalence of Factor V Leiden mutation among healthy individuals and patients with deep venous thrombosis in Lebanon: is the eastern Mediterranean region the area of origin of this mutation? Thromb Haemost 86(2):723–724PubMedGoogle Scholar

Copyright information

© Springer-Verlag 2005

Authors and Affiliations

  1. 1.Department of Internal Medicine, Faculty of MedicineAmerican University of Beirut Medical CenterBeirutLebanon

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