An Unusual Vascular Involvement in a Patient With Behcet’s Disease: Renal Artery Stenosis

Behçet's disease presenting as recurrent oral aphthosis in a 9-year-old boy from Greece

We report a case of Behçet's disease in a 9-year-old boy from Greece, presenting with a history of recurrent ulceration of the oral cavity. Following inspection of the oral cavity, which revealed lesions on both the upper and lower labial mucosa, as well as a large ulcer on the apex of the tongue, the diagnosis of Behçet's disease was immediately suspected. The diagnosis was confirmed using the International Criteria for Behçet's Disease. Nevertheless, as multiple diseases can cause recurrent oral aphthosis, an extensive differential diagnosis was made, and pertinent tests were undertaken to exclude other causes of oral ulceration. The approach to a patient with Behçet's disease, as well as its various clinical presentations and complications, is discussed.

Renal involvement in Chinese patients with Behcet's disease: a report of 16 cases

AIM

To investigate the clinical and pathological characteristics of renal involvement in Behcet's disease (BD).

METHODS

A retrospective analysis was carried out in BD patients complicated with renal damage who were hospitalized in Peking Union Medical College Hospital from June 1998 to July 2012.

RESULTS

There were 16 BD patients with renal involvement, accounted for 2.6% of all the 618 hospitalized BD patients. The presentation of renal disease was chronic glomerulonephritis in six patients (including one with nephritic syndrome), renal tubular acidosis in one patient, renal artery stenosis in eight patients and renal vein thrombosis in one patient. Renal biopsy was performed in five patients, three of whom revealed to have minor glomerular lesions, mild mesangial proliferative glomerulonephritis and chronic tubular-interstitial nephropathy, respectively. The other two patients underwent a second biopsy, the one with minor glomerular lesion in the first biopsy was transformed into grade III immunoglobulin A (IgA) nephropathy on Lee's glomerular grading system 6 years later, and the other one who had IgA nephropathy of grade II in the first biopsy was progressed to grade IV 2 years later. Among the nine patients with renal vascular involvement, two underwent surgery, and several received anticoagulant therapy. During the follow-up of 13 patients, the urine protein quantifications were reduced, and renal function remained relatively stable.

CONCLUSIONS

Renal damage is relatively uncommon in BD patients. There are various clinical presentations of renal involvement in BD. Routine screening with urinalysis, serum creatinine and imaging studies should be carried out for the early diagnosis of renal involvement in BD.

Successful Stent Implantation for Aortoiliac Bifurcation Stenosis in a Young Patient with Behçet's Disease

Behçet's disease (BD) is a multisystem vascular inflammatory disease. BD can affect blood vessels of nearly all sizes and types. Arterial involvement is a rare but serious condition in the course of BD. Here, we report a case of stenosis at the iliac artery bifurcation which was treated with percutaneous balloon angioplasty and stent implantation in a 37-year-old patient with BD.