Rapidly growing aortic arch aneurysm in Behcet's disease

Area of Science:

• Cardiovascular Medicine
• Rheumatology
• Vascular Surgery

Background:

• Behçet's disease (BD) is a rare multisystemic inflammatory disorder.
• Aortic aneurysms are a serious, though uncommon, manifestation of BD.
• Differentiating infectious from non-infectious aneurysms can be challenging.

Observation:

• A patient with a history of Behçet's disease developed a rapidly expanding aortic arch aneurysm.
• The aneurysm's appearance mimicked an infectious etiology, prompting initial antibiotic treatment.
• Despite treatment, persistent fever and elevated inflammatory markers suggested an alternative cause.

Findings:

• Surgical intervention revealed an aortic arch aneurysm measuring 5 cm.
• Pathological examination excluded bacterial infection and cystic medial necrosis.
• Inflammatory changes, particularly eosinophilic infiltration, were noted in the aortic adventitia.

Implications:

• This case highlights the diagnostic challenges in Behçet's disease-associated aortic aneurysms.
• Aggressive surgical management combined with prolonged antibiotic therapy may be beneficial.
• Understanding the inflammatory mechanisms in BD aneurysms is crucial for future treatment strategies.