Background Arterial involvements occur in less than 10 % of patients with Behçet’s disease (BD). Aneurysms are the most frequent lesions and constitute one of the mortality’s causes.
Objectives The aim of this study was to evaluate prevalence of aneurysms in BD in Tunisian patients and to describe clinical features, treatment and outcome of patients having this involvement.
Methods A retrospective study was made. Files of patients followed for BD (criteria of the International Study Group of BD) in our internal medicine department were studied. Patients having arterial aneurysms were included. Aneurysm diagnosis was confirmed, according to his location, using cerebral, thoracic or abdominal scanography, coronarography or doppler ultrasound.
Results Among 488 patients with BD, 25 had arterial aneurysms (5.1%). There were 23 men and 2 women. The mean age at the disease onset was 29 +/- 10.28 years, and was 33.84 +/- 10.14 years at BD diagnosis. Aneurysm revealed BD in 12 cases (2.4%). Abdominal aorta aneurysm was the most frequent (8 cases). Aneurysms in pulmonary arteries were confirmed in 7 cases and superficial femoral artery was involved in 2 patients. Other locations as primitive carotid artery, humeral artery, hypogastric artery, internal iliac artery, communal femoral artery, deep femoral artery, poplit artery and posterior tibial artery were noted each in only one case. Two patients underwent a myocardial infarction due to coronial artery aneurysm. Two patients had 2 different locations. All patients were symptomatic (abdominal pain, thoracic pain, limbs pain, gastrointestinal bleeding or haemoptysis). Comparison between patients with and without aneurysm showed that ocular involvement and HLA B51 were significantly less frequent in patients having aneurysm whereas deep venous thrombosis were significantly more frequent in these patients. All patients were treated by corticosteroids, 10 patients had surgery associated to immunosuppressive therapy (8 patients). The other patients had only immunosuppressive therapy. Only 2 patients had relapse. One patient died because of aneurysm rupture before any treatment.
Conclusions Arterial aneurysms are uncommon in BD. They were significantly associated to deep venous thrombosis. Aneurysms still being a serious complication in patients with BD, but treated early, the outcome is good.
Disclosure of Interest None Declared