Clinical characteristics and radiographic outcomes of vascular Behçet’s disease involving the aorta or its major branches

Optimal timing of surgical treatment for Behcet's disease aortic or peripheral artery pseudoaneurysms

OBJECTIVE

The aim of this study was to assess the optimal thresholds of surgical intervention for Behcet's disease (BD) aortic or peripheral artery pseudoaneurysms.

METHODS

This was a retrospective single-center study of 2138 patients with BD, including 96 patients with vascular BD (4.5%) with 151 pseudoaneurysms between January 2002 and December 2021. Factors associated with mortality were assessed using Cox regression model. The growth rate of each pseudoaneurysm was calculated based on available imaging data in a linear mixed effect model.

RESULTS

Patients in the surgical group (2/56) had significantly lower aneurysm-related mortality than those in the medical treatment group (10/33) (χ2 = 10.34; P = .0013). Surgical intervention (P = .009) and diameter of BD pseudoaneurysm (P = .006) were independently associated with BD aneurysm-related mortality. Rapid growth of BD pseudoaneurysm was achieved once diameter exceeded 4.0 cm for aortic pseudoaneurysm, or 2.5 cm for peripheral artery pseudoaneurysm, accompanied with high risk of rupture (Overall rupture rate: BD aortic pseudoaneurysm, ≥4.0 cm vs <4.0 cm: 63.6% vs 15.4%; BD peripheral artery pseudoaneurysm, ≥2.5 cm vs <2.5 cm: 50.9% vs 0).

CONCLUSIONS

This study verified the critical role of surgical intervention in reducing the mortality rate of patients with BD pseudoaneurysms. BD aortic pseudoaneurysms larger than 4.0 cm in diameter and peripheral artery pseudoaneurysms larger than 2.5 cm in diameter require prompt surgical intervention due to the remarkable increase in the growth rate and greater risk of rupture and death.

Enigmatic odyssey: A case of Behcet disease with atypical thrombotic complications

INTRODUCTION AND IMPORTANCE

Behçet disease is a rare, chronic, multi-systemic inflammatory disease of unknown origin that affects vessels in various organs. It is characterized by multiple clinical manifestations, most prominently oral and genital ulcers. Typically diagnosed in individuals aged 20 to 40 years with a male predominance, Behçet disease poses significant diagnostic and therapeutic challenges.

CASE PRESENTATION

We present a case concerning a 26-year-old female who was diagnosed with Behçet's disease nine years ago. This presentation is atypical for her age and gender. The patient has experienced recurrent thrombotic events, such as pulmonary embolism, a right pulmonary artery aneurysm, and right atrium intracardiac thrombosis.

CLINICAL DISCUSSION

This case underscores the atypical presentation of Behçet disease in a young female and highlights its potential for serious thrombotic complications. The recurrent thrombotic events observed in this patient necessitate a comprehensive understanding of the disease's pathophysiology and tailored therapeutic approaches.

CONCLUSION

Behçet disease can manifest with significant thrombotic complications, even in atypical patient populations. This case report highlights the necessity for heightened awareness and timely management of thrombotic events in individuals with Behçet disease to enhance outcomes.

A Case Report of Behcet's Disease With Thromboses in the Superior Vena Cava and External Iliac Vein

Behcet's disease (BD), also known as Behcet's syndrome, is a rare, chronic, autoimmune disorder of unknown origin. Its manifestations are thought to be caused by vasculitis, resulting in damage to blood vessels of all sizes throughout the body. We report a 25-year-old Pakistani male who is sexually active and presents with a one-year history of shortness of breath, cough, exertional dyspnea, and neck and facial swelling. On examination, he had severe anemia, mouth ulcers, distended neck and chest veins, prominent abdominal veins, and a scrotal ulcer. After going through mandatory investigations to evaluate the presenting signs and symptoms, thromboses were found in the major veins, including the superior vena cava (SVC) and external iliac vein, as well as a positive pathergy test. Accordingly, a diagnosis of Behcet’s disease with cardiomyopathy and venous thrombosis was made. He was treated with anticoagulants, steroids, and azathioprine for six months and subsequently went into remission.