Pulmonary Thromboembolism in Behcet’s Disease: A Case Report

Abstract

Behcet’s disease is a vasculitis which presents as recurrent oral and genital aphthous ulceration, uveitis and skin lesions. Unlike other types of vasculitis, venous system involvement is a common manifestation of Behcet’s disease. Despite the high incidence of deep vein thrombosis in Behcet’s disease, pulmonary artery thromboembolism (PTE) is a rare complication. In this article, we report on a 44-year old man who experienced recurring painful oral ulcers, bilateral panuveitis, superficial phlebitis and positive pathergy which had led to a diagnosis of Behcet’s disease 12 years earlier. He developed sudden onset dyspnea, pleuritic chest pain and hemoptysis two days before admission. The patient had tachypnea and mild respiratory distress at the time of admission. CT angiography showed filling defects in the inter-lobar arteries of both lungs with sub-segmental consolidation. A lung perfusion scan showed multiple segmental and sub-segmental perfusion defects in both lungs which did not match the ventilation scan. A diagnosis of PTE was made and anticoagulation with enoxaparin and warfarin was begun. The tachypnea, chest pain and hemoptysis disappeared after three days and he was discharged after 10 days with warfarin. His disease was in complete remission at eight months after discharge.