Multidisciplinary Team Describes Case of Vascular Behçet Syndrome

A multidisciplinary team described treatment provided to a man with Behçet syndrome (BS) who developed a saccular aneurysm in the posterior wall of the right common iliac artery, in a report in the journal Rheumatology.

“In a recent analysis, 45 (10.2%) of 441 BS patients had aneurysmal BS,” wrote clinicians Hacettepe University in Ankara, Turkey. “The distribution of involved arteries was as follows: 33.3% abdominal aorta; 30.8% pulmonary arteries; 25.6% iliac arteries; 12.8% femoral arteries; 10.3% thoracic aorta; and 38.5% of the aneurysms were saccular.”

Their specific case involved a 28-year-old man with a history of oral and genital ulcerations who was first seen in the clinic in February 2011. He was diagnosed with BS after a positive pathergy test and began treatment with colchicine. After he developed gastrointestinal side effects, he was switched to azathioprine.

Edema and pain in the left lower extremity a year later prompted venous Doppler ultrasound, which showed thrombi from the left crural veins to the common iliac vein, and from the right common iliac vein to the external iliac vein. A subsequent computed tomography scan revealed a saccular aneurysm in the posterior wall of the right common iliac artery.

The article described multidisciplinary-guided treatment over the next year and a half and, finally, endovascular treatment, in which the aneurysm was excluded.

“At the last follow-up in September 2019, he had no complaints,” the team reported, “and normal levels of acute phase reactants.”

—Jolynn Tumolo

Reference

Bilgin E, Sayinalp B, Eldem G, Karadag O. Iliac artery aneurysm in Behçet's syndrome: collaborative management is essential. Rheumatology. 2021;60(Supplement_3):iii32-iii34.