Tohoku J. Exp. Med., 2021 September, 255(2)
Vascular Behcet's Disease Preceded by Fever of Unknown Origin: Usefulness of Ultrasonography for the Detection of Large-Vessel Vasculitis
Haruki Matsumoto,1 Makiko Yashiro-Furuya,1 Yuya Fujita,1 Tomoyuki Asano,1 Tatsuhiko Mori,2 Shuzo Sato,1 Jumpei Temmoku,1 Naoki Matsuoka,1 Hiroshi Watanabe,1 Eiji Suzuki3 and Kiyoshi Migita1
1Department of Rheumatology, Fukushima Medical University School of Medicine, Fukushima, Fukushima, Japan
2Department of Dermatology, Fukushima Medical University School of Medicine, Fukushima, Fukushima, Japan
3Department of Rheumatology, Ohta Nishinouchi General Hospital Foundation, Koriyama, Fukushima, Japan
Behcet's disease is a systemic vasculitis characterized by oral and genital ulcers, erythema nodosum, and ocular involvement. Fever of unknown origin is a relatively rare event in Behcet's disease. We present the case of a 17-year-old male patient who suffered from prolonged fever for two months. The patient tested positive for HLA-B52 and levels of acute phase reactants were elevated. He complained of sore throat and neck pain that were evaluated by cervical ultrasonography, which revealed thickening of the carotid arterial wall and narrowing of the vessel lumen. The patient was diagnosed with vascular Behcet's disease and treated with glucocorticoid, which improved the clinical symptoms and thickening of the carotid arterial wall as detected by color duplex ultrasonography. Since vascular Behcet's disease may lead to morbidity and mortality, we suggest the early use of ultrasonography to help detect medium/large-vessel vasculitis. Prolonged fever in patients with Behcet's disease should be promptly evaluated for vascular involvement.
Keywords —— color duplex ultrasonography; fever of unknown origin; vascular Behcet's Disease
© 2021 Tohoku University Medical Press
Tohoku J. Exp. Med 2021, 255, 163-169.
Correspondence: Kiyoshi Migita, M.D., Ph.D., Department of Rheumatology, Fukushima Medical University School of Medicine, 1 Hikarigaoka, Fukushima, Fukushima 960-1295, Japan.