[Vasculo-Behcet's disease with fatal massive hemoptysis]

Area of Science:

• Internal Medicine
• Rheumatology
• Pulmonology

Background:

• Behcet's disease is a rare multisystem inflammatory disorder.
• Pulmonary involvement, though uncommon, can lead to severe complications.

Observation:

• A 39-year-old male presented with hemoptysis and was diagnosed with Behcet's disease.
• Imaging revealed pulmonary artery opacities, and deep-vein thrombosis was confirmed.
• The patient had a history of characteristic mucocutaneous lesions and a positive needle test.

Findings:

• Despite treatment with prednisolone, colchicine, and indomethacin farnesil, the patient experienced fatal massive hemoptysis.
• Autopsy revealed a ruptured bronchial artery aneurysm and inferior vena cava thrombotic vasculitis.
• Pulmonary vasculitis-induced hemoptysis occurs in 5-10% of Behcet's disease patients.

Implications:

• This case highlights Behcet's disease as a critical, albeit infrequent, cause of hemoptysis.
• Early recognition and aggressive management of pulmonary vasculitis in Behcet's disease are crucial.
• The poor prognosis underscores the need for increased awareness among clinicians.