Behcet hastaligina eslik eden bilateral subklaviyan ven ve vena cava superiyor trombozu/Bilateral subclavian vein thrombosis and vena cava superior syndrome with Behcet's disease.Behcet hastaligi kronik, insamatuvar, multisistemik bir hastali ktir (1). Oral aftlar, genital ulserler ve goz tutulumu hastaligin onde gelen bulgularidir. Kardiyovaskuler sistem tutulumu (yuzeyel trombosebit, arteryel-venoz trombozis, anevrizma, kardiyak trombus vs.) ise santral sinir sistemi tutulumu ile birlikte Behcet Hastaligi'na bagli mortalitenin onde basta gelen sebebidir (2).Alti yil once Behcet hastaligi tanisi alan 34 yasindaki erkek hasta, 5 yildir eforla artan dispne, boyunda sislik ve kizariklik, gogus bolgesindeki yuzeyel damarlarda genisleme sikayetleri ile basvurdu. Fizik muayenesinde boyunda kizariklik, her iki omuz, boyun ve gogus on duvarinda Valsalva manevrasi ile belirginlesen yaygin dilate dilate /di·late/ (di´lat) to stretch an opening or hollow structure beyond its normal dimensions. di·late v. To make or become wider or larger. venoz kollateraller gozlendi. Hastada santral venoz okluzyon olabilecegi dusunuldu. Yapilan venoz duplex Doppler ultrasonografi ve venografik incelemelerde, bilateral subklaviyan, brakiosefalik venler ve superiyor vena cava da total okluzyona yol acan kronik trombozis ve venoz kollateraller oldugu goruldu (Resim 1 ve Resim 2). Hastanin ozgecmis ve diger laboratuvar incelemelerinde vena cava superiyor trombozu nedeni olabilecek baska bir patolojiye rastlanmadi. [ILLUSTRATION OMITTED] Behcet hastaliginda fibrinolitik aktivitede azalma ve endotel disfonksiyonuna sekonder trombosit agregasyonunda artis tespit edilmistir (3). Vena cava superiyor trombozu ise; basta intratorakal tumorler olmak uzere paraneoplastik sendromlar, santral kateterizasyon, cerrahi girisim, mediastinal mediastinal /me·di·as·ti·nal/ (-as-ti´n'l) of or pertaining to the mediastinum. mediastinal of or pertaining to the mediastinum. fibrozis ve Behcet hastali gi gibi vaskulit veya hiperkoagulabilite tablosu olusturan diger durumlarda gozlenebilir (1,4). Ust ekstremite venoz tromboz ve vena cava superiyor trombozu meydana gelen olgularda, bilinen klasik risk faktorleri (malignite, kateterizasyon, cerrahi girisim) yoksa Behcet hastaligi akla gelmelidir. Kaynaklar (1.) Castelli P, Caronno R, Piffaretti G, Tozzi M, Lomazzi C, Lagan Lagan (lăg`ən), river, c.40 mi (60 km) long, rising in Slieve Croob, SE Northern Ireland. It flows NW, then NE past Lisburn to Belfast Lough at Belfast. D, et al. Endovascular treatment for superior vena cava superior vena cava n. Abbr. SVC A large vein formed by the union of the two brachiocephalic veins and the azygos vein that receives blood from the head, neck, upper limbs, and chest, and empties into the right atrium of the heart. obstruction in Behcet disease. J Vasc Surg 2005; 41: 548-51. (2.) Imai Y. Studies on prognosis and symptoms of Behcet's disease in long term observation. Jap Clin Opthalmol 1971; 25: 665-94. (3.) Ozatli D, Sayinalp N, Buyukasik Y, Karakus S, Haznedaroglu IC, Kirazli S, et al. Unchanged global fibrinolytic fibrinolytic pertaining to or emanating from fibrinolysis. fibrinolytic agent substances that stimulate or inhibit fibrinolysis. fibrinolytic inhibitors include e-aminocaproic acid and antiplasmin-a1. capacity despite increased factor VIIa activity in Behcet's disease: evidence of a prethrombotic state. Rheumatol Int 2002; 21: 137-40. (4.) May M, Seehafer M, Helke C, Uberruck T, Gunia S, Hoschke B. Superior vena cava syndrome Superior Vena Cava Syndrome Definition The superior vena cava is the major vein in the chest that carries blood from the upper part of the body in to the heart. with bilateral jugular jugular /jug·u·lar/ (jug´u-lar) 1. cervical. 2. pertaining to a jugular vein. 3. a jugular vein. jug·u·lar adj. and subclavian vein thrombosis. Paraneoplastic paraneoplastic /para·neo·plas·tic/ (-ne?o-plas´tik) pertaining to changes produced in tissue remote from a tumor or its metastases. paraneoplastic auxiliary to neoplasia. manifestation of renal cell carcinoma renal cell carcinoma or hypernephroma Malignant tumour of the cells that cover and line the kidney. It usually affects persons over age 50 who have vascular disorders of the kidneys. It seldom causes pain, unless it is advanced. . Urologe A 2003; 42: 1374-7. Yazisma Adresi: Dr. Muzaffer Bahcivan, Ondokuz Mayis Universitesi, Tip Fakultesi, Kardiyovaskuler Cerrahi Anabilim Dali, 55139 Kurupelit, Samsun, Turkiye Tel.: 0362 457 60 00/3110 Faks: 362 457 60 41 E-mail: mbahcivan@omu.edu.tr Muzaffer Bahcivan, Semih Yucel Ondokuz Mayis Universitesi, Tip Fakultesi, Kardiyovaskuler Cerrahi Anabilim Dali, Samsun, Turkiye |
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