AB0056 RADIOLOGICAL EVALUATION OF PULMONARY ARTERY THROMBOSIS IN PATIENTS WITH BEHCET’S DISEASE
Authors: S. A. Germe, Z. Özsoy, B. Bulat, G. Durhan, B. Firlatan, L. Kiliç, A. Akdoğan
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> Pulmonary vascular involvement is a significant cause of morbidity and mortality in Behcet's disease (BD) patients. Pulmonary arterial aneurysms and pulmonary artery thrombosis (PAT) are the most commonly observed lesions. Although deep vein thrombosis is common in patients with BD, pulmonary embolism is considered to be rare in BD patients due to the inflammatory nature of venous lesions. <h3>Objectives:</h3> This study aims to define the radiological characteristics of PAT in BD patients. <h3>Methods:</h3> 165 BD patients with vascular involvement who applied to the rheumatology outpatient clinic between 2017 and 2022 were evaluated retrospectively. Among the patients with venous involvement (n=146), we identified 65 patients who had undergone thorax computed tomography (CT) imaging in the previous years. Fourteen patients who were diagnosed with PAT were included in the study. An expert radiologist re-evaluated the thorax CT scans of the 14 patients and identified the PAT as acute or chronic based on their radiological features. The patients' ages, genders, disease durations, and symptoms were noted during their CT scans. Patients put on new or escalated immunosuppressive treatment were considered to have active disease. <h3>Results:</h3> The patients' median age was 35 (min: 15-max: 60) years at the time of the CT scan, and nine were male. Eight patients already had BD diagnosis, and the median disease duration of these patients at the time of the CT scan was 11.5 (min: 5-max: 31) years. Six patients were newly diagnosed. Upon re-evaluation of the thorax CTs, it was observed that acute PAT was diagnosed in 6 (42.8%) patients; chronic PAT was detected in 8 (57.1%) patients. Two patients with chronic PAT also had acute PAT. Pulmonary artery aneurysms were present in 3 (21.4%) patients and intracardiac thrombus was found in 3 (21.4%) patients. Twelve (85.7%) patients were symptomatic; the most common symptom was dyspnea (64.2%). Following the detection of PAT on CT scans, treatment was modified in 12 (85.7%) patients, considering that the disease was active. Of the two patients whose treatment was not changed, one presented with chronic PAT while utilizing azathioprine, colchicine, warfarin. The other patient's present state, characterized by acute PAT, was considered to be a consequence of her recent surgical procedure on the lower extremities. <h3>Conclusion:</h3> A significant number of BD patients with venous involvement had radiological findings consistent with acute PAT potentially due to pulmonary emboli in this study. The clinical importance of these lesions has to be defined with future studies. <h3>REFERENCES:</h3> [1] Ruggiero A, Screaton NJ. Imaging of acute and chronic thromboembolic disease: state of the art. Clin Radiol. 2017 May;72(5):375-388. [2] Wittram C, Kalra MK, Maher MM, Greenfield A, McLoud TC, Shepard JA. Acute and chronic pulmonary emboli: angiography-CT correlation. AJR Am J Roentgenol. 2006 Jun;186(6 Suppl 2):S421-9. <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> <b>None declared.</b>