Gomaa Mahmoud, Elshaer Osama
Wexner Medical Center, The Ohio State University, Columbus, Ohio, USA; Department of Cardiovascular Medicine, Kafrelsheikh University Hospital, Kafrelsheikh, Egypt.
Department of Cardiovascular Medicine, Kafrelsheikh University Hospital, Kafrelsheikh, Egypt.
JACC Case Rep. 2025 Aug 20;30(24):104663. doi: 10.1016/j.jaccas.2025.104663.
Behçet disease is a rare multisystem vasculitis that may affect the coronary arteries, presenting as acute coronary syndrome (ACS) in young patients without risk factors.
A 26-year-old man with recurrent oral ulcers experienced chest pain over 3 months. Coronary angiography revealed multivessel disease, and a subsequent angiogram showed coronary aneurysms, suggesting vasculitis. Behçet disease was diagnosed based on the International Criteria for Behçet's Disease and HLA-B51 positivity. The patient improved with corticosteroids and colchicine.
In young patients presenting with ACS and no significant risk factors for atherosclerosis, Behçet disease should be considered as a potential cause of coronary artery vasculitis. Coronary aneurysms may be an associated finding.
TAKE-HOME MESSAGES: Vasculitis should be considered in the differential diagnosis for young patients with ACS without significant cardiovascular risk factors. Behçet disease can lead to coronary artery aneurysms; early recognition and management are critical.
白塞病是一种罕见的多系统血管炎，可累及冠状动脉，在无危险因素的年轻患者中表现为急性冠状动脉综合征（ACS）。
一名26岁反复口腔溃疡的男性在3个月内出现胸痛。冠状动脉造影显示多支血管病变，随后的血管造影显示冠状动脉瘤，提示血管炎。根据白塞病国际诊断标准及HLA - B51阳性确诊为白塞病。患者使用皮质类固醇和秋水仙碱后病情改善。
在无明显动脉粥样硬化危险因素而出现ACS的年轻患者中，应考虑白塞病为冠状动脉血管炎的潜在病因。冠状动脉瘤可能是相关表现。
对于无明显心血管危险因素的年轻ACS患者，鉴别诊断时应考虑血管炎。白塞病可导致冠状动脉瘤；早期识别和治疗至关重要。
