Pediatric Behcet's Disease and Thromboses

Objective. To describe the characteristics of a group of pediatric patients with Behcet's disease (BD) who presented at least 1 episode of thrombosis during their disease course. Methods. We made a retrospective chart review of the clinical, biological, and radiological data of children with BD who presented at least I episode of either arterial or venous thrombosis. Data were extracted from both an international pediatric Behcet cohort and files referred from 7 French centers. Results. Twenty-one patients were included. Diagnosis of BD was based on the criteria of the International Study Group for BD. Main locations for thrombosis were the cerebral sinuses, in 11 patients (52.4%); and lower limbs, in 9 patients (40.9%). Recurrent episodes were observed in 4 patients (21%). Thrombophilia measurements were normal in 14 patients out of 21, while anticardiolipin antibodies were positive in 4 patients, and 2 out of 21 had protein C deficiency. One patient had lupus anticoagulant. All patients were treated with colchicine. Corticosteroids were also added for variable periods in 13 patients. Five patients out of 21 were treated with anticoagulants (heparin, then anti-vitamin K) and 3 with antiplatelets (acetylsalicylic acid). Conclusion. Thromboses are a serious complication of BD and may occur early in the disease course. The presence of thrombophilic markers could increase the risk of thrombosis in BD, but the size of our population does not allow any conclusion. An international cohort (PED-BD) is currently in place and will allow study of such cases longitudinally, as well as assessment of the elements that correlate with an increased risk of thrombosis in children with BD. (First Release Nov 15 2010; J Rheumatol 2011;387-90; doi:10.3899/jrheum.100257)