[Case of vascular Behçet's disease initially presented with Bürger's disease-like vasculitides]

The patient was a 24-year-old man. Bürger's disease was diagnosed initially based on the finding of bilateral radial artery obstruction, and the patient underwent vascular reconstructive surgery. After the operation, however, formation of false aneurysms was observed frequently in the left brachial artery at the elbow, which necessitated performance of vascular reconstructive surgery up to five times in total, including of the right common femoral artery, which had been punctured several times for investigational procedures. During the clinical course, fever, oral aphthoid ulcers, genital ulcers, and nodular erythema appeared, and incomplete Behçet's disease was diagnosed. Histopathological examination suggested that the vascular lesion was consistent with necrotizing angiitis. The systemic inflammatory findings and angiitis improved following steroid administration. Vascular Behçet's disease is known as a special type of Behçet's disease, but usually develops in the patients with a long history of the disease. Our patient was believed to be very instructive because, when Behçet's disease occurs with angiitis and the epidemiological characteristics agree with those of Bürger's disease like in our patient, differentiation may be difficult.