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Thrombophilic factors are not the leading cause of thrombosis in Behçet’s disease
  1. M Leiba1,
  2. U Seligsohn2,
  3. Y Sidi1,
  4. D Harats3,
  5. B A Sela4,
  6. J H Griffin5,
  7. A Livneh6,
  8. N Rosenberg2,
  9. I Gelernter7,
  10. H Gur1,
  11. M Ehrenfeld1
  1. 1Department of Internal Medicine C, Sheba Medical Centre,Tel-Hashomer, Israel
  2. 2Thrombosis and Haemostasis Research Institute, Sheba Medical Centre
  3. 3Institute of Lipid and Atherosclerosis Research, Sheba Medical Centre
  4. 4Institute of Chemical Pathology, Sheba Medical Centre
  5. 5Department of Molecular and Experimental Medicine, Scripps Research Institute, La Jolla, California, USA
  6. 6Department of Internal Medicine F, Sheba Medical Centre
  7. 7Statistics Laboratory, Tel-Aviv University, Ramat-Aviv, Israel
  1. Correspondence to:
    Dr M Ehrenfeld
    Department of Medicine C, Sheba Medical Centre, Tel-Hashomer 52621, Israel; ehrenfelpost.tau.ac.il

Abstract

Background: Venous and arterial thromboses occur in patients with Behçet’s disease and are associated with significant morbidity and mortality. Studies on a possible association between the occurrence of thrombosis and thrombophilia in patients with this disease have been controversial.

Objective: To determine the prevalence of the most common thrombophilias and dyslipidaemia in patients with Behçet’s disease with and without thrombosis.

Methods: Blood samples from 107 patients with Behçet’s disease who had or did not have thrombosis were analysed for factor V Leiden, prothrombin G20210A polymorphism, methylenetetrahydrofolate reductase (MTHFR) C677T polymorphism, factor VIII level, homocysteine and C reactive protein concentrations, dyslipidaemia, and plasma glucosylceramide.

Results: There was no difference between patients with and without thrombosis in the prevalence of prothrombin G20210A polymorphism, factor V Leiden, homozygous MTHFR C677T, or plasma concentrations of homocysteine, C reactive protein, or glucosylceramide. In contrast, patients with thrombosis were found to have significantly higher mean levels of factor VIII, total cholesterol, triglycerides, VLDL cholesterol, and apolipoproteins B-100, C-II, and C-III than those without thrombosis. Multistepwise logistic regression analysis showed that triglyceride concentration was the best marker associated with thrombosis (p = 0.008), with an estimated odds ratio of 1.58 (95% confidence interval, 1.09 to 2.30) for a difference of 40 mg/dl.

Conclusions: Thrombophilia does not seem to play a major role in the tendency to thrombosis in Behçet’s disease. However, dyslipidaemia, predominantly hypertriglyceridaemia, might be a risk factor.

  • DVT, deep vein thrombosis
  • Lp(a), lipoprotein (a)
  • MTHFR, methylenetetrahydrofolate reductase
  • SVT, superficial vein thrombosis
  • Behçet’s disease
  • thrombophilia
  • dyslipidaemia
  • factor VIII

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Footnotes

  • We thank Professor David Steinberg from the Statistics Laboratory, Tel-Aviv University, for his advice in the statistical analyses, Dr Hiroshi Deguchi and Ms Young Mee Lee (The Scripps Research Institute) for measuring plasma glucosylceramide, and Dr Adi Leiba, Department of Internal Medicine D, Sheba Medical Centre, for invaluable assistance and support.

    Grant support: Katznelbogen grant, Sackler Faculty of Medicine, Tel-Aviv University; and National Institutes of Health grant HLZ1544.