The following is a summary of “Angiographic findings of pulmonary arterial involvement in Behcet’s Disease: Do they correlate with symptoms and acute phase response?,” published in the January 2024 issue of Pulmonology by Aksoy, et al.
Behcet’s disease (BD) is a chronic inflammatory disorder characterized by arterial vasculitis. While pulmonary artery aneurysm (PAA) is considered the prototypic arterial disorder, recent studies have reported an increasing presence of pulmonary artery thrombosis (PAT) with or without aneurysms.
For a study, researchers sought to describe computed tomography pulmonary angiography (CTPA) findings of pulmonary involvement in BD and correlate them with symptoms and acute phase response (APR).
The retrospective study assessed 153 CTPA scans of BD patients by two radiologists. Clinical and laboratory data were collected from patient files. Pulmonary artery involvement (PAI) was defined as a thrombus or aneurysm in CT angiography.
Most patients (85.6%) were male, with a median age of 33.7 ± 10 years during angiographic assessments. Of the angiographies, 40.5% presented a thrombus: 14 subsegmental, 29 segmental, 13 lobar, and 6 in the main branches. Among these, 82.3% (n = 51) had bilateral involvement. Isolated PAT was present in 93.5% of angiographies, with only 2.6% displaying an aneurysm together with a thrombus. Pulmonary infarction was detected in 9 angiographies. Nearly one-third of patients (29.3%), mostly under immunosuppressive treatments for other indications, were screened for asymptomatic pulmonary involvement (without any symptoms or increased APR), and one-fourth were diagnosed with segmental or subsegmental PAT.
The study found that isolated pulmonary thrombosis is the primary form of PAI, while isolated pulmonary aneurysm formation is rare in BD cases. In patients with pulmonary symptoms, especially males, involvement of segmental or more proximal parts of pulmonary arteries is commonly detected. Approximately one-fourth of asymptomatic male BD patients showed PAI on CTPA screening.
The results suggested that BD patients with pulmonary symptoms should undergo CTPA screening for PAI, but further research was needed to clarify the role of routine CTPA screening in asymptomatic BD patients.
Source: resmedjournal.com/article/S0954-6111(23)00369-4/fulltext