Behçet's disease and thrombosis: a single centre experience from an academic tertiary reference hospital

ABSTRACT Behçet’s disease (BD) is a rare immune mediated variable-vessel vasculitis that can affect virtually any organ or system. The natural history of the disease is characterized by a relapsing and remitting course, which ca ben controlled with the use of anti-inflammatory and immunomodulatory agents. Among the most common clinical manifestations of the disease, there is the increased tendency to develop vascular complications, particularly in the form of deep vein thrombosis (DVT). Great efforts have been made in order to understand the pathophysiological mechanisms at the basis of this increased thrombotic tendency and the most accredited hypothesis sees an inflammation-induced endothelial damage as the culprit lesion. Recently, also the role of platelets in the development of thrombosis has been investigated in the context of Behçet’s disease, and an interesting interplay between thrombocytes and inflammatory cells seems to be an important part of the pathogenic process. Two studies already explored the possibility of seeing alterations in platelet parameters, most of all in mean platelet volume (MPV), in patients developing thrombotic complications, which could provide a valid tool for the stratification of patients on the basis of their thrombotic risk. This study wanted to investigate first of all the prevalence and epidemiology of venous thromboembolism in a cohort of patients with confirmed diagnosis of Behçet’s disease with gastrointestinal manifestations. Secondly, through a careful anamnestic and laboratory evaluation we tried to establish whether there is a statistical difference between the blood test results of Behçet’s patients with and without DVT and to compare them with a group of healthy controls. As a last point we were hoping to confirm the presence of a correlation between the thrombotic risk of the patients and their mean platelet volume results. Unfortunately, due to several limitations and to the small size of our sample, especially the one of DVT patients, no statistically relevant outcomes resulted from the comparison of DVT and non DVT Behçet’s patients, although differences are present especially when taking into consideration inflammatory parameters. Moreover, also MPV failed to confirm what was proposed previously by Iranian and Turkish authors. To date, further studies need to be performed on a larger sample and on a longer period of time, in order to have the possibility to assess the changes in laboratory parameters and investigate the possibility of stratifying patients thrombotic risk on their basis.