Sapporo Medical University School of Medicine
Correspondence to: Satoru Yoshida, MD, Department of Radiology, Muroran City General Hospital, Yamate-chou 3–8-1, Muroran 051-8512, Japan; e-mail: email@example.com
To the Editor:
We read with interest the review by Mogulkoc and
colleagues (August 2000)1regarding intracardiac thrombus
in 24 patients with Behçet disease previously published in 21
reports. It is also noted that the authors suggest a unique geographic
distribution of this condition in the Mediterranean basin and the
Middle East. However, several important articles2–4 from
the Far East are not mentioned in the review article, although it is
well-known that Japan is one of specific areas to have a high
prevalence of Behçet disease. We report herein a case of
Behçet disease with cardiac and pulmonary arterial thrombus from
a radiologic point of view.
A 19-year-old Japanese man was admitted to our hospital in
January 1996 due to hemoptysis and right heart failure. He had
undergone the surgical removal of right ventricular thrombus at another
hospital 9 months previously. He received a diagnosis of incomplete
Behçet disease based on oral ulceration, skin lesion, uveitis,
and positive human leukocyte antigen-B51. Enhanced helical CT (Fig 1
, top, middle) revealed thrombus of the right
atrium, right ventricle, and right pulmonary artery. Indium-111
platelet scintigraphy (Fig 1, bottom) showed strong uptakes
in the right-sided heart and right pulmonary hiatus suggesting acute
thrombus formations. Scintigraphy clarified the activity of thrombus
and contributed to determining the therapeutic strategy against the
serious complications of Behçet disease.
Helical CT can be helpful in the assessment of thoracic manifestations
of Behçet disease including thrombus of the systemic veins,
heart, and pulmonary arteries.2 To our knowledge, there
have been no reports of the use of indium-111–labeled platelet
scintigraphy in cardiac thrombus in Behçet
disease.1–5 Scintigraphy can be used to determine whether
a thrombus is acute or chronic.6
The selection of key words for a computerized search of the medical
literature using the National Library of Medicine’s MEDLINE is
important. Our case and several reported cases2–5
strongly suggest that the Far East should be included among the
specific geographic distribution of patients with cardiac thrombus in
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