Atypical Presentation of Behçet Disease Unmasked by Acute Coronary Syndrome.

BACKGROUND

Behçet disease is a rare multisystem vasculitis that may affect the coronary arteries, presenting as acute coronary syndrome (ACS) in young patients without risk factors.

CASE SUMMARY: A 26-year-old man with recurrent oral ulcers experienced chest pain over 3 months. Coronary angiography revealed multivessel disease, and a subsequent angiogram showed coronary aneurysms, suggesting vasculitis. Behçet disease was diagnosed based on the International Criteria for Behçet's Disease and HLA-B51 positivity. The patient improved with corticosteroids and colchicine.

DISCUSSION: In young patients presenting with ACS and no significant risk factors for atherosclerosis, Behçet disease should be considered as a potential cause of coronary artery vasculitis. Coronary aneurysms may be an associated finding.

TAKE-HOME MESSAGES: Vasculitis should be considered in the differential diagnosis for young patients with ACS without significant cardiovascular risk factors. Behçet disease can lead to coronary artery aneurysms; early recognition and management are critical.