Behçet syndrome — SCE Rheumatology MCQ

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ModerateVasculitisBehçet syndromeSCE Rheumatology

A 32-year-old man has recurrent painful oral ulcers, genital ulcers and episodic blurred vision from posterior uveitis. He also reports acneiform lesions and a positive pathergy test. There is no inflammatory bowel disease and ANCA is negative. What is the most likely diagnosis?

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Correct answer: C — Behçet syndrome

Explanation lettering: E = shown as B · D = shown as C · C = shown as D · B = shown as E

Behçet syndrome is best because recurrent oral and genital ulceration with posterior uveitis and pathergy supports Behçet syndrome. A is less suitable because reactive arthritis usually follows infection with oligoarthritis and conjunctivitis rather than posterior uveitis; B is less suitable because Crohn's can cause ulcers and eye disease but pathergy and recurrent genital ulcers point to Behçet; C is less suitable because herpes alone does not explain posterior uveitis and pathergy; E is less suitable because SLE would have lupus serology and systemic immune-complex features. Clinical pearl: ocular Behçet is sight-threatening and needs prompt specialist therapy.

Reference: BSR-BAD Behçet living guideline 2025