Predictors for the Risk and Severity of Post Thrombotic Syndrome in Vascular Behcet's Disease.

Abstract Objectives Deep venous thrombosis (DVT) of the lower extremities (LE) is the most common form of vascular involvement in Behcet’s disease (BD), leading frequently to post-thrombotic syndrome (PTS) as a disabling complication. We aimed to describe clinical characteristics and predictors of PTS presence among BD patients with LE-DVT, assessing also with venous Doppler ultrasonography (US). Methods Patients with BD (n=205, M/F: 166/39, age: 39±9.5 years) with a DVT history were investigated. Villalta scale was used to assess the presence and severity of PTS. Doppler US was performed within 1 week of clinical evaluation. Total number of vessels with reflux, thrombi, recanalization andcollaterals were calculated. Results Among BD patients, 62% had PTS and 18% had severe PTS. Patients with PTS had higher reflux (p=.054) and thrombosis scores (p=.02) compared to patients without PTS. Treatment with anticoagulation (AC), immune-suppressives (IS) or AC in combination with IS drugs did not affect PTS presence, however patients treated with IS with/without AC drugs had decreased severe PTS compared to anticoagulation-treated only group (p=.017). Patients treated with AC+ISs also had increased collateral scores compared to patients treated with only ISs. Interferon-α use seem to provide better recanalization scores compared to azathioprine only ((1.0 (0-14) versus 2.5(0-10), p=0.010)) Conclusion BD patients with DVT have a high risk of severe PTS. Immuno-suppressive treatment decreases severe PTS development. Anti-coagulation may influence the course of PTS by increasing the collateral scores and interferon-α (IFN- α) also increases recanalization scores. Routine assessment with Doppler US can be helpful for the prediction of severe PTS.