Vascular Involvement in Behçet's Disease: Diagnostic Value and Clinical Implications

Behçet's disease is a multisystemic vasculitis diagnosed based on the Classification Criteria for Behçet's Disease. The asynchronous presentation of symptoms and their classification into major and minor signs can complicate diagnosis, often resulting in delays in diagnosis and treatment. Currently, vascular involvement accounts for only one point in the classification score despite being potentially the most life-threatening manifestation of the disease. This article presents the case of a young man with a history of recurrent oral ulcers, who was admitted as an emergency for a ruptured popliteal artery aneurysm. The initial evaluation did not meet the diagnostic threshold based on international criteria, thus delaying the initiation of appropriate immunosuppressive therapy. During follow-up, the disease progressed with a new aneurysm in the common femoral artery. This case advocates for reconsidering the importance of vascular involvement in the diagnostic scoring system for Behçet's disease, in order to avoid dangerous diagnostic and therapeutic delays in angio-Behçet.