Vascular Behçet’s Disease: A Case of Arterial Occlusion and Successful Medical Management

TL;DR

A young man with Behçet’s disease experienced arterial occlusion but improved with medical treatment, avoiding surgery.

Contribution

This case demonstrates successful non-surgical treatment of vascular Behçet’s disease in a young patient.

Findings

The patient showed rapid clinical improvement with corticosteroids and azathioprine.

Vascular lesions stabilized on follow-up imaging without invasive intervention.

Immunosuppressive therapy achieved favorable outcomes in a case of arterial occlusion.

Abstract

Behçet’s disease is a rare, chronic, multisystem vasculitis that can involve arteries and veins of all sizes, with vascular manifestations representing some of its most severe and potentially life‐threatening complications. Arterial involvement is uncommon but clinically significant, particularly in young patients. We report the case of a 26‐year‐old Palestinian male with a history of recurrent oral and genital ulcerations who presented with persistent left inguinal and proximal thigh pain accompanied by localized inflammatory signs. Laboratory investigations revealed elevated inflammatory markers and leukocytosis. Computed tomography angiography demonstrated complete occlusion of the left common femoral, external iliac, profunda femoris, and superficial femoral arteries, without evidence of distal ischemia or tissue compromise. Based on the combination of characteristic mucocutaneous manifestations and imaging findings, a diagnosis of vascular Behçet’s disease was established. The patient was treated conservatively with high‐dose systemic corticosteroids in combination with azathioprine, along with low‐dose aspirin. He showed rapid clinical improvement, with complete resolution of symptoms and stabilization of vascular lesions on follow‐up imaging. No surgical or endovascular intervention was required. This case highlights the importance of considering Behçet’s disease in young patients presenting with unexplained arterial occlusion and demonstrates that, in carefully selected cases without critical ischemia, timely immunosuppressive therapy may achieve favorable clinical and radiological outcomes while avoiding invasive interventions.

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