Assessment of Carotid-vertebral Artery and Renal Artery Doppler Ultrasound in the Behçet’s Disease with Cutaneous Lesions

Abstract

Objective: Behçet’s disease (BD) is a chronic multisystem inflammatory disease of unknown etiology defined as recurrent aphthous oral and genital ulcers, skin lesions, and uveitis. BD is a type of systemic vasculitis that can affect arteries regardless of origin and size-the co-occurrence of chronic systemic vasculitis and acute systemic inflammation results in an endothelial abnormality of the vessels. The morphological thickness of the arterial wall is a crucial feature of atherosclerosis. Carotid intima-media thickness (IMT) is an endothelial cell dysfunction parameter associated with atherosclerosis. This study aimed to evaluate the hemodynamic properties of carotid-vertebral and renal arteries of BD with cutaneous lesions to prove the effects of subclinical morphology of atherosclerosis. Methods: The study consisted of 23 BD patients with oral and genital aphthae or cutaneous lesions. Color Doppler and B-mode ultrasonography examinations of the carotid-vertebral and renal arteries were performed in all patients. The assessment of the vascular structures included IMT, plaque thickness, resistive index, pulsatility index, peak systolic velocity, end-diastolic velocity, and the volumes of both kidneys were measured in the study. In addition, the flow rates of both vertebral arteries were calculated. Results: The most intriguing findings of our study were the detection of non-stenotic plaque in 3 patients, mild intimal thickening in most patients, and vertebra basilar insufficiency in 12 patients. In addition, hemodynamic alterations of the patient’s carotid arteries were compatible with the reported findings in the literature. Age, gender, disease duration, ophthalmic and neurological involvement, and IMT correlation were evaluated with the chi-square test, and no statistically significant correlation was found in this study. However, in the Mann-Whitney U test, a significant positive correlation was detected between kidney volume and IMT (p<0.035). Conclusion: We found no significant differences in vascular changes secondary to early atherosclerosis compared with the average population and literature in Behçet patients with cutaneous lesions. The increase in kidney size may be one of the early signs of atherosclerosis in Behçet’s cases.