Spot diagnosis

An otherwise healthy 29-year-old female presents to the ED with new onset blurred vision.

She mentions a history of recurrent oral aphthous ulcers and occasional painful genital lesions over the past year.

On examination, well-defined oral ulcerations and vulvar scarring are seen. Bilateral inflammation throughout the uveal tract is evident on slit lamp examination.

Which of the following is this patient most at risk of developing?

  • Accelerated atherosclerosis
  • Chronic pancreatitis
  • Vulvar cancer
  • Pulmonary artery aneurysm

Image credit: @RNHutson.

Answer: This patient’s presentation is indicative of Behçet’s disease, a rare vasculitic disorder. Although oral and urogenital lesions, and ocular disease are hallmark features of the disorder, there can also be neurologic, vascular, cardiac, renal, gastrointestinal, and pulmonary manifestations. A pulmonary artery aneurysm is the most common pulmonary vascular lesion associated with this disease.​

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