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Background: Behcet's Disease (BD) is a multisystemic disorder characterised by recurrent oral and genital ulcers (1). Vasculitis and thrombotic events are the most important causes of mortality (2). Thrombosis is the major clinical finding in 3-7% of the patients with BD but the cause of the thrombosis is still unclear (3). Thromboelastography (TEG) is an alternative method to conventional coagulation tests to evaluate almost all steps of the hemostatic system. Today, the modified rotation thromboelastogram (ROTEM) is a newer and more powerful technique.
Objectives: Our aim in this study was to investigate tendency to thrombosis in patients with BD using ROTEM.
Methods: 20 BD patients, who fulfilled ISGB criteria for BD (4), followed by Eskisehir Osmangazi University, Faculty of Medicine, Division of Rheumatology and 14 healthy controls who are not taking antiaggregant or anti-coagulant therapy were included to study. Whole blood count, PT, aPTT, fibrinogen, D-dimer levels and ROTEM parameters; clotting time (CT), clot formation time (CFT) and maximum clot formation (MCF) were determined by INTEM and EXTEM analysis. Statistical analysis were performed using SPSS 15.0 for Windows, and the results were analysed using Spearman correlation test and T-test (independent samples).
Results: The mean age of the BD patients was 41.3±2.5 years. The female: male ratio was 13/7. One of the patients has a previous history of thrombosis and 2 had thrombosis with uveitis. Nine of the patients had mucocutaneous symptoms and 8 had eye involvement.
Comparison of TEG parameters showed that there was a significant increase in MCF (p<0,001) by INTEM and EXTEM assays in the study group compared to control group. INTEM-MCF and EXTEM-MCF also showed positive correlation with platelet numbers (p<0.001 and p<0.05, respectively).
Conclusions: The present data demonstrated thromboelastographic evidence of hypercoagulability in patients with Behcet's Disease which was determined by an increase of the clot strength as identified by increasing of MCF. ROTEM also determined the contribution of platelets to clot strength very well in Behcet's Disease patients.
References:
1. Lee YJ, Kang SW, Yang JI, Choi YM, Sheen D, Lee EB, Choi SW, Song YW. Coagulation parameters and plasma total homocysteine levels in Behçet's disease. Thrombosis Research 106(2002) 19-24
2. Leiba M, Sidi Y, Gur H, Leiba A, Ehrenfeld M. Behçet's disease and thrombophilia. Ann Rheum Dis 2001;60:1081-1085
3. Leiba M, Seligsohn U, Sidi Y, Harats D, Sela BA, Griffin JH, Livneh A, Rosenberg N, Gelernter I, Gur H, Ehrenfeld M. Thrombophilic factors are not the leading cause of thrombosis in Behçet's disease. Ann Rheum Dis 2004;63:1445-1449
4. Wechsler B, Davatchi F, Hamza M et. al. Criteria for diagnosis of Behcet's disease. International Study Group for Behcet's disease. Lancet. 1990;335:1078-80
Disclosure of Interest: None Declared