Budd-Chiari syndrome in Behçet's disease: a retrospective multicenter study.

OBJECTIVE: To compare the clinical features, laboratory findings, and prognosis of Behçet's disease (BD) patients with and without Budd-Chiari syndrome (BCS). METHODS: This multicenter retrospective study investigated 61 (M/F: 41/20) patients with BD, having coexistent BCS, and 169 (M/F:100/69) BD patients as the control group without BCS from 22 different centers of Turkey diagnosed between 1990 and 2017. RESULTS: Of the total 61 BD patients with BCS, the onset of the first symptom and the median age of diagnosis were earlier in contrast to BD patients without BCS (p = 0.005 and p = 0.007). Lower extremity deep vein and inferior vena cava (IVC) thrombosis were more common in patients with BCS (all; p < 0.01) compared to the control group. Mortality was significantly higher in BD-BCS patients with IVC thrombosis than in the controls (p = 0.004). Since most of the cases in our cohort had chronic and silent form of BCS, mortality rate was 14.8%, which was on the lower range of mortality rate reported in literature (14-47%). While all BD-BCS patients received immunosuppressive (IS) agents, only half of them received additional anticoagulant treatments. Among IS agents, interferon treatment was more frequently used in this cohort (19%), compared to other series reported in literature (2.3%). CONCLUSION: To our knowledge, this is the largest series of BD patients with BCS. Our patients had earlier disease onset and diagnosis, higher frequency of IVC thrombosis, and higher mortality rate, compared to BD patients without BCS. Mortality was significantly higher in BD-BCS patients with IVC thrombosis compared to controls. Key Points • Mortality rate is higher in BD-associated BCS patients with IVC involvement. • Chronic and silent form of BD-associated BCS has a better prognosis. • The main treatment options are corticosteroids and immunosuppressive agents, whereas anticoagulant treatment remains controversial.

Does metabolic syndrome increase erectile dysfunction and lower urinary tract symptoms.

PURPOSE: To evaluate the impact of metabolic syndrome (MS) on erectile dysfunction (ED) and lower urinary tract symptoms (LUTS). MATERIALS AND METHODS: We included patients who had presented at the urology outpatients with LUTS or ED complaints and at the endocrinology outpatients for diabetes between May 2012 and April 2013. MS was present in 50 of the 107 patients (42.7%). The blood pressure, fasting blood sugar, serum lipid profile, triglyceride, total cholesterol, body mass index (BMI) and total prostate specific antigen (PSA) values were recorded. The international prostate symptom score (IPSS), quality of life score and international erectile function index (IIEF-5) values were determined for the patients. All patients also underwent uroflowmetry together with prostate volume and residual urine volume measurement. RESULTS: There was a significant negative correlation between the IPSS and IIEF scores of the patients (P < .001, r = -0.42). There was no significant difference regarding IPSS scores between patients with and without MS (P = .6), while the IIEF-5 scores were significantly lower in the MS group (P = .03). CONCLUSION: We found that metabolic syndrome did not significantly affect LUTS but could significantly contribute to ED. We therefore feel patients presenting with ED complaints should also be carefully evaluated for MS.