Increased Frequency of Obstructive Sleep Apnea Syndrome in Behcet’s Syndrome Patients with Vena Cava Superior Thrombosis

Aycan Gokturk¹, Sinem Nihal Esatoglu¹, Yesim Ozguler¹, Ersan Atahan², Benan Musellim², Vedat Hamuryudan¹, Hasan Yazici³ and Emire Seyahi¹, ¹Istanbul University, Cerrahpasa Medical Faculty, Department of Internal Medicine, Division of Rheumatology, Istanbul, Turkey, ²Istanbul University, Cerrahpasa Medical Faculty, Department of Pulmonary Medicine, Istanbul, Turkey, ³Istanbul Academic Hospital, Istanbul, Turkey

Meeting: 2018 ACR/ARHP Annual Meeting

Keywords: Behcet's syndrome and thrombosis

Session Information

Date: Monday, October 22, 2018

Title: Vasculitis Poster II: Behҫet’s Disease and IgG4-Related Disease

Session Type: ACR Poster Session B

Session Time: 9:00AM-11:00AM

Background/Purpose: Superior vena cava syndrome (SVCS), is a medical emergency and can also be seen in Behçet’s syndrome (BS). Contrary to the severe outcome seen in malign conditions, SVCS in BS usually has a benign course, complicated rarely by hemoptysis, pleural effusion and a chylothorax. We had noted that BS patients with SVCS frequently complained of sleep disturbances, snoring and sleep apnea, suggesting an obstructive sleep apnea (OSA) disorder. We formally surveyed the degree of risk for OSA among BS patients with SVCS and suitable controls using the Berlin questionnaire, a screening questionnaire for OSA with a high sensitivity and modest specificity (1). Methods: Because of the lower frequency of female patients with VCSS (n= 2), only males were included. We studied 28 BS patients with SVCS (Group 1), 80 BS patients with vascular involvement without a SVCS (Group 2), and 59 BS patients with no vascular involvement (Group 3). Also 80 apparently healthy individuals (Group 4) of similar age and gender to BS patients were studied. The Berlin questionnaire was used to assess risk of OSA (1). Polysomnography was performed in patients at high risk for OSA according to the Berlin questionnaire. Results: There were no differences regarding demographic characteristics, disease duration and variables associated with OSA among the groups (Table). The Berlin questionnaire categorized 57.1 % (16/28) of the BS patients with SVCS (Group 1) as having a high risk for OSA and this was significantly higher compared to that found in the control groups. The frequency of those at high risk for OSA was 15 %, 8.5 %, 11.3 % in Group 2, 3 and 4, respectively (p>0.05). Until now, polysomnography was performed in 12 subjects (5 patients with SVCS, 1 patient with vascular involvement without a SVCS and 6 healthy controls). OSA was detected in 3/5 patients with SVCS and 1/1 patient with vascular involvement without a SVCS and 4/6 healthy controls. Conclusion: This study shows that BS patients with a history of VCSS are at high risk of OSA. This is probably due to the external pressure of the significant venous collaterals on the upper airways. Reference: 1: Netzer NC, Stoohs RA, Netzer CM, Clark K, Strohl KP. Using the Berlin Questionnaire to identify patients at risk for the sleep apnea syndrome. Ann Intern Med. 1999 Oct 5;131(7):485-91

Table. Demographic characteristics and variables associated with obstructive sleep apnea
	Group 1 (BS patients with SVCS) (n=28)	Group 2 (BS patients with vascular involvement without SVCS) (n=80)	Group 3 (BS patients with no vascular involvement) (n=59)	Group 4 (Healthy controls) (n=80)	p value
Age, mean ± SD, years	44.3 ± 9.7	42. 1 ± 7.8	41.9 ± 5.9	42.7 ± 9.7	0.051
Disease duration, mean ± SD, years	18.7 ± 9.4	14.6 ± 7.7	12.5 ± 6.5		*0.001*
Hypertension, n (%)	4 (14.3)	6 (7.5)	2 (3.4)	4(5)	NS
BMI, mean ± SD	26.8 ± 4.7	26.4 ± 3.9	26.2 ± 3.3	27.0 ± 3.5	NS
High risk for OSA, n (%)	16 (57.1)	12 (15)	5 (8.5)	9 (11.3)	*< 0,001*

Disclosure: A. Gokturk, None; S. N. Esatoglu, None; Y. Ozguler, None; E. Atahan, None; B. Musellim, None; V. Hamuryudan, None; H. Yazici, None; E. Seyahi, None.

To cite this abstract in AMA style:

Gokturk A, Esatoglu SN, Ozguler Y, Atahan E, Musellim B, Hamuryudan V, Yazici H, Seyahi E. Increased Frequency of Obstructive Sleep Apnea Syndrome in Behcet’s Syndrome Patients with Vena Cava Superior Thrombosis [abstract]. Arthritis Rheumatol. 2018; 70 (suppl 9). https://acrabstracts.org/abstract/increased-frequency-of-obstructive-sleep-apnea-syndrome-in-behcets-syndrome-patients-with-vena-cava-superior-thrombosis/. Accessed .

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