Colchicine therapy for deep vein thrombosis in a patient with vascular-type Behçet disease

Abstract

Rationale: Behçet Disease (BD) is a chronic inflammatory vasculitis with thrombogenicity and multisystem involvement. Deep vein thrombosis (DVT) in the lower extremities is the most frequent manifestation of vascular involvement in BD. The causes of thrombosis vary widely and include congenital predisposition and acquired factors, but of all the thrombosis, the cause is rarely BD. Furthermore, there are few reports of treatment for thrombosis in BD.Patient concerns: We herein describe the case of an Asian male patient aged 40 years, admitted to our hospital for left leg pain, edema, and swelling.Diagnoses: We confirmed the DVT and pulmonary artery thrombosis (PAT) by contrast computed tomography angiogram. At the same time, the patient developed oral ulcerations and skin lesions consistent with BD. Interventions:The patient was initially treated with anticoagulants. However, because the improvement of DVT was inadequate, we added colchicine in anticipation of anti-inflammatory effects. After that, anticoagulation was discontinued, and only colchicine was continuously prescribed.Outcomes: We observed an almost complete resolution of DVT and PAT with no recurrence of thrombosis for 6 months after discharge.Lessons: This case shows us that we should consider BD as a differential diagnosis of DVT and that colchicine therapy is effective for inflammation-induced thrombosis in BD. Abbreviations: BD = Behçet disease, CT = computed tomography, DOAC = direct oral anticoagulant, DVT = deep vein thrombosis, NSAIDs = non-steroidal anti-inflammatory drugs, PAT = pulmonary artery thrombosis.

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