Asian Journal of Case Reports in Medicine and Health

Introduction: Arterial aneurysmal involvement in Behçet’s disease represents one of the most severe vascular manifestations and constitutes a major therapeutic challenge. This is a serious vascular complication, occurring in 3-5% of cases, often in young people. It results from an intense inflammatory process affecting the vascular wall, leading to destruction of the elastic and muscular components of the artery and consequently promoting the formation of pseudoaneurysms. These lesions are particularly concerning because of their often rapid and unpredictable progression, with a high risk of spontaneous rupture that may be life-threatening. The most frequently reported locations involve the pulmonary arteries, the aorta, and peripheral arteries, particularly the femoral arteries.

The management of these vascular complications primarily relies on strict control of inflammation through intensive immunosuppressive therapy aimed at stabilizing the disease and preventing the progression of vascular lesions. Surgical or endovascular intervention may subsequently be required in certain situations, particularly in the presence of large, symptomatic aneurysms or those at high risk of rupture. However, these procedures remain technically challenging due to the underlying inflammatory environment and the risk of aneurysmal recurrence or postoperative complications.

Hughes–Stovin syndrome is a rare disorder of still poorly understood etiology, characterized by the association of pulmonary artery aneurysms and deep venous thrombosis, and is often considered a particular or incomplete form of Behçet’s disease. We report the case of a patient hospitalized in the internal medicine department in whom the diagnosis of Behçet’s disease was established, presenting an exceptional vascular manifestation consisting of a thrombosed aneurysm of the left superficial femoral artery associated with Hughes–Stovin syndrome.

This case highlights the potential severity of arterial involvement in Behçet’s disease and emphasizes the importance of early diagnosis and prompt multidisciplinary therapeutic management. Close clinical and radiological monitoring is essential to detect early progression of vascular lesions and to reduce the risk of severe complications, particularly aneurysmal rupture, massive hemorrhage, and related morbidity.

Case Report: We report the case of a patient with Behçet’s disease presenting an unusual vascular manifestation consisting of a thrombosed aneurysm of the left superficial femoral artery associated with pulmonary artery aneurysm and deep venous thrombosis, suggesting Hughes-Stovin syndrome.

Discussion / Conclusion: Arterial aneurysmal involvement in Behçet’s disease represents a severe and potentially life-threatening manifestation. Early recognition and prompt initiation of immunosuppressive therapy combined with appropriate vascular intervention are essential to prevent catastrophic complications such as aneurysmal rupture.

Regular follow-up and strict therapeutic adherence are crucial to detect new vascular lesions and improve long-term prognosis.