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Alamlih LI, Abdulla N, Awad AM, Arayssi T. Renal arteriovenous fistula in Behçet's disease. Rheumatology (Oxford) 2021; 60:e169-e170. [PMID: 33433622 DOI: 10.1093/rheumatology/keaa756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2020] [Revised: 09/28/2020] [Accepted: 10/13/2020] [Indexed: 11/14/2022] Open
Affiliation(s)
| | - Nabeel Abdulla
- Division of Rheumatology, Department of Internal Medicine
| | - Ahmad Mohamed Awad
- Intervention Radiology, Department of Radiology, Hamad Medical Corporation
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Planer D, Verstandig A, Chajek-Shaul T. Transcatheter embolization of renal artery aneurysm in Behçet’s disease. Vasc Med 2016. [DOI: 10.1177/1358836x0100600207] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
A 20-year-old man with Behç et’s disease presented with a ruptured renal artery aneurysm. This patient had previously had aneurysms of the coronary arteries and coronary vein thrombosis that were treated with immunosuppression. A selective transcatheter embolization of the renal artery branch was done successfully and treatment with corticosteroids and methotrexate was added. Presented here is a rare complication of Behçet’s disease, with discussion on the pathophysiology, differential diagnosis, and the advantages and disadvantages of the angiographic treatment. This paper is supplemented with a comprehensive review of the literature.
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Affiliation(s)
- D Planer
- Department of Medicine, Hadassah University Hospital, Mount Scopus, Jerusalem, Israel
| | - A Verstandig
- Department of Radiology, Hadassah University Hospital, Ein Kerem, Jerusalem, Israel
| | - T Chajek-Shaul
- Department of Medicine, Hadassah University Hospital, Mount Scopus, Jerusalem, Israel,
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3
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Multiple left ventricular aneurysms in a young female. Rev Port Cardiol 2016; 35:113.e1-6. [PMID: 26852308 DOI: 10.1016/j.repc.2015.09.020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2014] [Revised: 07/18/2015] [Accepted: 09/02/2015] [Indexed: 11/22/2022] Open
Abstract
Multiple left ventricular aneurysms (LVAs) are rare, especially in a young female. A 29-year-old woman presented vague symptoms. Multiple LVAs were revealed and confirmed on different imaging modalities, including chest radiography, echocardiography, contrast ventriculography and cardiac magnetic resonance imaging. Detailed work-up for probable etiologies including ischemic, infectious, inflammatory and autoimmune causes was negative. In the absence of angina, decompensated congestive heart failure, arrhythmias and embolism, the patient was managed conservatively, with excellent mid-term outcome.
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Multiple left ventricular aneurysms in a young female. REVISTA PORTUGUESA DE CARDIOLOGIA (ENGLISH EDITION) 2016. [DOI: 10.1016/j.repce.2016.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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5
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Successfully treated isolated renal artery pseudoaneurysm in a patient with Behçet's disease. Kidney Res Clin Pract 2015; 35:123-6. [PMID: 27366669 PMCID: PMC4919565 DOI: 10.1016/j.krcp.2015.09.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2015] [Revised: 08/24/2015] [Accepted: 09/04/2015] [Indexed: 11/24/2022] Open
Abstract
Renal artery aneurysms and pseudoaneurysms are an uncommon clinical problem with a low incidence rate. They are abnormal dilatations of the vessel lumen with some different natures. However, the rupture of an aneurysm and pseudoaneurysm is the most dreaded complication because it causes death of the patient. There are many causes of renal artery aneurysm and pseudoaneurysm, including Behçet's disease; however, renal involvement in Behçet's disease is less frequent. We report a case of renal artery pseudoaneurysm induced by Behçet's disease and treated successfully with coil embolization. A 56-year-old woman with Behçet's disease presented with an incidental left renal artery pseudoaneurysm measuring 18 mm. We successfully performed endovascular treatment with coil embolization instead of surgical treatment.
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Yokota K, Akiyama Y, Sato K, Shindo Y, Yoshida Y, Miyoshi F, Akiba H, Nakajima K, Asanuma Y, Mimura T. Vasculo-Behçet’s disease with non-traumatic subcapsular hematoma of the kidney and aneurysmal dilatations of the celiac and superior mesenteric arteries. Mod Rheumatol 2014. [DOI: 10.3109/s10165-008-0091-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
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Sezen Y, Buyukhatipoglu H, Buyukatipoglu H, Kucukdurmaz Z, Geyik R. Cardiovascular involvement in Behçet's disease. Clin Rheumatol 2009; 29:7-12. [PMID: 19830382 DOI: 10.1007/s10067-009-1302-0] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2009] [Accepted: 10/05/2009] [Indexed: 12/16/2022]
Abstract
Behçet's disease is a chronic relapsing systemic vasculitis that can involve almost every organ and systems in the body with extremely different diverse manifestations. Cardiovascular involvement is one of these manifestations, the involvement of which might present in various patterns in itself. Cardiovascular involvement is relatively uncommon in Behçet's disease; however, Behçet's disease is relatively rather common in certain parts of the world. Therefore, especially in these locations recognizing such miscellaneous presentations are of critical importance, since cardiovascular involvements exceed other presentation in mortality and morbidity rates. Based on these facts, in this review, we summarized the cardiovascular involvements and its different manifestations in Behçet's disease.
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Affiliation(s)
- Yusuf Sezen
- Department of Internal Medicine, Harran University School of Medicine, Sanliurfa, Turkey
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Interventional radiology in the diagnosis, management, and follow-up of pseudoaneurysms. Cardiovasc Intervent Radiol 2008; 32:2-18. [PMID: 18923864 DOI: 10.1007/s00270-008-9440-3] [Citation(s) in RCA: 60] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2008] [Revised: 08/15/2008] [Accepted: 09/03/2008] [Indexed: 02/05/2023]
Abstract
Arterial wall disruption, as a consequence of inflammation/infection, trauma (penetrating or blunt), or iatrogenic causes, may result in pseudoaneurysm formation. Currently, iatrogenic causes are increasing as a result of the growth of endovascular intervention. The frequency of other causes also seems to be increasing, but this may simply be the result of increased diagnosis by better imaging techniques, such as multidetector contrast-enhanced computed tomography. Clinically, pseudoaneurysms may be silent, may present with local or systemic signs, or can rupture with catastrophic consequences. Open surgical repair, previously the mainstay of treatment, has largely been replaced by image-guided occlusion methods. On the basis of an experience of over 100 pseudoaneurysms, treatments at various anatomical sites, imaging modalities used for accurate diagnosis, current changing therapeutic options for pseudoaneurysm management, approved embolization agents, and clinical follow-up requirements to ensure adequate treatment will be discussed. Image-guided direct percutaneous and endovascular embolization of pseudoaneurysms are established treatment options with favorable success rates and minimal morbidity. The pendulum has now swung from invasive surgical repair of pseudoaneurysms to that of image-guided interventional radiology.
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Delgado V, Sitges M, Vidal B, Paré C. Seudoaneurisma gigante del ventrículo izquierdo y enfermedad de Behçet. Rev Esp Cardiol (Engl Ed) 2008. [DOI: 10.1157/13125529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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11
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Yokota K, Akiyama Y, Sato K, Shindo Y, Yoshida Y, Miyoshi F, Akiba H, Nakajima K, Asanuma Y, Mimura T. Vasculo-Behçet's disease with non-traumatic subcapsular hematoma of the kidney and aneurysmal dilatations of the celiac and superior mesenteric arteries. Mod Rheumatol 2008; 18:615-8. [PMID: 18563289 DOI: 10.1007/s10165-008-0091-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2008] [Accepted: 05/01/2008] [Indexed: 10/21/2022]
Abstract
We report a patient with vasculo-Behçet's disease treated successfully with a high dose of prednisolone. In 2002, the patient was diagnosed with vasculo-Behçet's disease. He was admitted to our hospital because of sudden-onset right lower back pain in June 2006. Upon admission, abdominal angiography revealed aneurysmal dilatations of the celiac and superior mesenteric arteries. He was treated promptly with high-dose prednisolone, after which the aneurysms displayed no further enlargement. As we believe this case to be quite rare, we report this case with a literature review in support of this characterization.
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Affiliation(s)
- Kazuhiro Yokota
- Department of Rheumatology and Applied Immunology, Faculty of Medicine, Saitama Medical University, 38 Morohongo, Moroyama-machi, Iruma-gun, Saitama, 350-0495, Japan
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Paul M, Schäfers M, Grude M, Reinke F, Juergens KU, Fischbach R, Schober O, Breithardt G, Wichter T. Idiopathic left ventricular aneurysm and sudden cardiac death in young adults. ACTA ACUST UNITED AC 2006; 8:607-12. [PMID: 16864613 DOI: 10.1093/europace/eul074] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
AIMS We report three young patients presenting with life-threatening ventricular tachycardia (VT) or ventricular fibrillation (VF) and/or survived sudden cardiac arrest, who were admitted to our institution for further diagnostic evaluation. METHODS AND RESULTS In all patients, idiopathic left ventricular (LV) aneurysms were identified after a detailed non-invasive and invasive evaluation. Sustained VT/VF was inducible during programmed ventricular stimulation in two of the three patients. Left ventricular aneurysms were depicted and characterized by various imaging modalities (echocardiography, magnetic resonance imaging, LV angiography). To elucidate the pathogenesis further, both myocardial viability and regional sympathetic innervation were assessed by radionuclide imaging techniques. Defects of innervation and metabolism were documented in the area of the aneurysm but distal to the aneurysm there were no signs of downstream denervation. CONCLUSION Life-threatening arrhythmias may be the first manifestation of an idiopathic LV aneurysm, which can be reliably diagnosed with modern imaging techniques. Radionuclide imaging may yield additional information as to the involvement of the autonomic nervous system potentially associated with arrhythmogenesis. Management strategies in patients with an idiopathic LV aneurysm range from antiarrhythmic drug treatment, implantation of an automatic cardioverter-defibrillator to surgical aneurysmectomy.
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Affiliation(s)
- Matthias Paul
- Department of Cardiology and Angiology, University Hospital of Münster, Albert-Schweitzer-Str. 33, D-48149 Münster, Germany.
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El Kharras A, Salaheddine T, Aziz N, Jidal M, Chaouir S, Benameur M. Une cause rare d’hématurie : rupture d’anévrisme de l’artère rénale. ACTA ACUST UNITED AC 2005; 86:954-6. [PMID: 16342882 DOI: 10.1016/s0221-0363(05)81475-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
The authors report a case of ruptured renal artery aneurysm in a 78 year old patient presenting with macroscopic hematuria. The rare occurrence of this entity and the value of imaging for diagnosis are discussed.
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Affiliation(s)
- A El Kharras
- Service d'imagerie médicale, Hôpital Militaire d'Instruction Mohamed V, Rabat, Maroc.
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Moudouni SM, En-Nia I, Rioux-Leclercq N, Guille F, Lobel B. Solitary contralateral adrenal metastasis after nephrectomy for renal cell carcinoma. Urol Int 2003; 68:295-8. [PMID: 12053036 DOI: 10.1159/000058454] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Malignant involvement of the contralateral adrenal gland in cases of renal cell carcinoma is extremely rare. Solitary metachronous metastatic involvement of the contralateral adrenal gland from renal cell carcinoma is rarely diagnosed during life. In fact, clinical signs and symptoms of adrenal insufficiency are rare in these patients. We report a case of renal cell carcinoma with solitary metachronous contralateral adrenal metastasis occurring 9 years after radical nephrectomy.
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Affiliation(s)
- S M Moudouni
- Department of Urology, University Medical Center Pontchaillou, Rennes, France.
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Akpolat T, Akkoyunlu M, Akpolat I, Dilek M, Odabas AR, Ozen S. Renal Behçet's disease: a cumulative analysis. Semin Arthritis Rheum 2002; 31:317-37. [PMID: 11965596 DOI: 10.1053/sarh.2002.31721] [Citation(s) in RCA: 86] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVE To analyze cumulated data about renal involvement in Behçet's disease (BD) and to report on 6 patients with BD and renal problems. METHODS We found reports of 159 patients (including our patients) with BD and specific renal disease (amyloidosis 69, glomerulonephritis [GN] 51, renal vascular disease 35, and interstitial nephritis 4) in our survey. RESULTS The frequency of renal problems among BD patients has been reported to vary between 0% to 55%. Male gender is a risk factor for all types of renal BD. Nephrotic syndrome was present in 83% of patients with amyloidosis, and renal failure was common at the time of diagnosis. The mean interval between the initial manifestation of BD and diagnosis of amyloidosis was shorter in men than in women (P =.02). AA-type amyloid fibrils were shown in all cases studied. Vascular involvement was common in the patients with amyloidosis (60%). The renal findings in GN show a wide spectrum, from asymptomatic hematuria and/or proteinuria to rapidly progressive GN. Several types of glomerular lesions ranging from minor glomerular changes to crescentic glomerulonephritis are observed in BD. The common types of glomerular lesions among the reported cases are crescentic GN, proliferative GN, and immunoglobulin A (IgA) nephritis. Aneurysms may be located throughout the renal artery, from the orifice of the main artery to intrarenal microaneurysms. Another type of renal disease (amyloidosis or GN) and other major vascular involvement were present in all cases with renal vein thrombosis. Hypertension is common among patients with renal artery aneurysm or stenosis. Microscopic vascular disease was described in 4 patients. CONCLUSIONS Based on data in the literature, we suggest that renal involvement in BD is more frequent than has been recognized, although it is most often mild in nature. Amyloidosis is one of the prognostic factors affecting survival. Patients with vascular involvement carry high risk for amyloidosis, and administration of colchicine to these patients may be beneficial. More evidence is needed to accept interstitial nephritis as a manifestation of BD. In spite of some difficulties, hemodialysis and renal transplantation are safe treatment options in BD-related uremia.
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Affiliation(s)
- Tekin Akpolat
- Ondokuz Mayis University School of Medicine, Samsun-Turkey.
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