Background Behcet's disease is a systemic vasculitis with a tropism for the venous system. Arterial involvement is uncommon (1%) and mainly represented by aneurysms that can be life-threatening.
Objectives This retrospective study was conduced in the internal medicine department of the University Hospital Ibn Rochd of Casablanca, over a period of thirty-five years between 1980 and 2016. Where included all the cases of Behcet's disease diagnosed in our service (1618 case).
Methods We aimed to determine the epidemiological profile, the different possible clinical manifestations and to discuss both prognosis and treatment in such cases.
Results 37 patients – 32 men and 5 women – presented arterial involvement in type of arterial aneurysm, which represents a rate of 2.35%.
Mean age at diagnosis was 32 years old (ranges 17–54). This complication was the revealing event for Behcet's disease in 2 cases, concomitant in 3 cases and occurring after an average of 6-year-period evolution of the disease in 32 cases.
The aneurysm affected: the pulmonary artery (22 cases), the abdominal aorta (5 cases), the femoral artery (5 cases), the internal carotid artery (2 cases), the iliac artery (2 cases) and the middle cerebral artery (1 case). The aneurysm was associated with venous disease (18 cases), pulmonary embolism (2 cases) and intracardiac thrombus (1 case).
The medical treatment has relying on anticoagulants (6 cases), anti-aggregating agents (9 cases), corticosteroids (36 cases), immunosuppressive drugs – cyclophosphamide (23 cases) and azathioprine (12 cases), while 7 patients underwent surgical intervention.
Evolution was favorable in 23 patients and with negative outcome in 14 patients (9 relapses and 5 deaths).
Conclusions Arterial aneurysms are the most common arterial complications in the context of Behcet's disease, while the prognosis remains poor in the absence of early and appropriate management (corticosteroids, immunosuppressive agents, surgery).
Disclosure of Interest None declared