Behçet’s disease presenting with Budd–Chiari syndrome and intracardial thrombus: a case report

Minji Jennifer Kim¹, Yong Suk Jo², Jee Hyun Kim², Yong-Jin Kim³, Kyung Hwan Kim⁴, Eun Bong Lee², Yeong Wook Song², Eun Young Lee^2
1School of Medicine, University of Manchester, Manchester, UK; ²Division of Rheumatology, ³Division of Cardiology, Department of Internal Medicine, ⁴Department of Thoracic Surgery, Seoul National University College of Medicine, Seoul, Republic of Korea

Abstract: Budd–Chiari syndrome has been described as a late complication of Behçet’s disease. Although the mortality rate associated with Behçet’s disease is low, it can escalate in the presence of Budd–Chiari syndrome and may be further complicated by intracardial thrombus formation. It is therefore important to detect and initiate management early in the disease course. The imaging modalities of choice should be minimally invasive as certain procedures may aggravate Behçet’s disease by initiating a thrombosis or aggravating an existing one. In Behçet’s disease-induced Budd–Chiari syndrome, cardiac investigation is crucial in the work-up in order to identify any cardiac involvement and determine the etiology of intracardial thrombus. Furthermore, the treatment should ultimately focus on controlling the activity of Behçet’s disease. We report an unusual case of Behçet’s disease presenting with Budd–Chiari syndrome complicated by intracardial thrombus in a young Korean man.

Keywords: Behçet’s disease, Budd–Chiari syndrome, intracardial thrombus