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Clinical Rheumatology

, Volume 35, Issue 10, pp 2501–2507 | Cite as

Intracardiac thrombus in patients with Behcet’s disease: clinical correlates, imaging features, and outcome: a retrospective, single-center experience

  • Hui Wang
  • Xiaoxiao Guo
  • Zhuang TianEmail author
  • Yongtai Liu
  • Qian Wang
  • Mengtao Li
  • Xiaofeng Zeng
  • Quan Fang
Original Article

Abstract

Intracardiac thrombus (ICT) is a rare but serious complication of Behcet’s disease (BD). The study was to report the clinical characteristics, imaging features, treatment, and outcomes of BD patients with ICT in a single tertiary center. A series of 626 BD patients admitted to Peking Union Medical College hospital between April 2003 and April 2013 were reviewed. A total of 12 (1.9 %) BD patients with ICT were included. ICT was presenting manifestation of BD in 5 of the 12 patients (41.7 %) and occurred mostly in men (9/12, 75 %) younger than 40 years. Patients with ICT had more arterial (66.7 vs. 7.3 %, p < 0.001) and venous involvement (75.0 vs. 8.1 %, p < 0.001) compared to those without ICT. Right heart was the most frequent site of ICT (11/12, 91.7 %). Thrombus were hyperechogenic and immobile with a broad-based attachment on echocardiography in most cases (11/12, 91.7 %). Cardiac magnetic resonance (CMR) was performed in four patients. All thrombi showed isointense on T1-weighted image, while all but one were hypointense on T2-weighted image without delayed enhancement. Remission of ICT was associated with therapy of anticoagulant, corticosteroid, and immunosuppressant in most cases (10/12, 83.3 %). There was no death, and relapses of ICT occurred in only one patient after tapering of immunosuppressant during follow-up. A diagnosis of BD should be considered when a young male patient presents with a mass in the right-sided heart accompanied by vascular lesions. Medical therapy especially adequate immunosuppressants might be the first choice for BD patients with ICT.

Keywords

Behcet’s disease Cardiac magnetic resonance Echocardiography Intracardiac thrombus 

Notes

Compliance with ethical standards

Disclosures

None.

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Copyright information

© International League of Associations for Rheumatology (ILAR) 2016

Authors and Affiliations

  • Hui Wang
    • 1
  • Xiaoxiao Guo
    • 1
  • Zhuang Tian
    • 1
    Email author
  • Yongtai Liu
    • 1
  • Qian Wang
    • 2
  • Mengtao Li
    • 2
  • Xiaofeng Zeng
    • 2
  • Quan Fang
    • 1
  1. 1.Department of Cardiology, Peking Union Medical College HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina
  2. 2.Department of Rheumatology, Peking Union Medical College HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina

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