Iliac Primitive Aneurysm Revealing Behçet Disease

Thirty-one year old woman with a history of recurrent oral aphtosis presented a leg swelling, pain and functional impairment. A venous thrombosis of the left ilio-femoro-popliteal was diagnosed and the patient received an anticoagulation therapy. One month later, she presented an arterial aneurysm of the right primitive iliac artery confirmed by an angio-CT exam. Physical examination revealed necrotic pseudofolliculitis, a bilateral posterior uveitis with papillitis. The diagnosis of BD was made. A corticosteroid treatment was conducted (solumedrol 1g/day for 3 days then 1 mg/kg/day of prednisone equivalent for 6 weeks then progressively tapered until 10 mg/day) associated with cyclophosphamide (1g/month for 12 months). An angio CT scan 12 months later was performed and objectivated the progression in size of the aneurysm. Therefore, a surgical treatment was decided and consisted on a lay flat of the aneurysm and graft interposition with polytetrafluoroethylene prosthesis. The post-operative outcome was favorable.