Behcet's disease with involvement of major arteries: a case report

Vascular involvement is not infrequent in Behcet's disease (BD). It is generally seen in the form of superficial thrombophlebitis or occlusion of major veins. In rare instances, arterial occlusion and aneurysm formation may be seen in BD. We reported a young male with BD, diagnosed at the age of twenty for relapsing and remitting oral ulceration, skin rash, arthralgia and ocular painful redness for three years. At the age of 21, he had recurrent abdominal aortic aneurysm and inconspicuous neurological manifestations including dizziness, tinnitus and transients of blurred vision. The carotid angiography disclosed the occlusion of bilateral common carotid arteries (CCA). A carotid endarterectomy was subsequently performed to reduce the risk of stroke. The pathological examination of the occluded segment of CCA revealed chronic inflammation, which was attributable to BD. There was no atherosclerotic change. To the best of our knowledge, this is the first case report of concurrent bilateral CCA occlusion and relapsing abdominal aortic aneurysm. Even in the absence of specific neurological symptoms, we suggest that cerebrovascular investigation need to take into consideration in BD patients with unexplained cranial symptoms.