Behcet Disease — SCE Rheumatology MCQ

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ModerateVasculitisBehcet DiseaseSCE Rheumatology

A 40-year-old man has Behçet syndrome, with recurrent oral and genital ulceration, erythema nodosum-like lesions, posterior uveitis and a positive pathergy test. Which of the following manifestations carries the greatest risk of disease-related mortality?

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Correct answer: A — Pulmonary artery aneurysm

**C. Pulmonary artery aneurysm** is the best answer. Major vascular involvement is a principal cause of death in Behçet syndrome, particularly in young men. Pulmonary artery aneurysms may rupture, producing life-threatening massive haemoptysis; arterial involvement is independently associated with increased mortality. Posterior uveitis is potentially sight-threatening and therefore causes major morbidity, but it is not the strongest mortality predictor among these options. Oral and genital ulcers and erythema nodosum-like lesions may substantially impair quality of life but do not usually cause irreversible organ damage or death. Behçet-associated peripheral arthritis is typically episodic and non-erosive. Neurological and gastrointestinal involvement can also confer a poor prognosis, but neither is offered here.

Reference: Saadoun D, et al. Mortality in Behçet's disease. Arthritis & Rheumatism. 2010;62(9):2806–2812. https://pubmed.ncbi.nlm.nih.gov/20496419/