A case of Behçet's disease with newly emerged vascular lesion after tonsillectomy

Abstract

A 19-year-old female who had been diagnosed as Behçet's disease because of oral aphthae, genital ulcers, erythema nodosum and iridocyclitis underwent bilateral tonsillectomy because of chronic tonsillitis with a hope of improvement of Behçet's disease.
Although major manifestations disappeared, she complained of fever and abdominal pain and weakness of the left radial pulsation was noted, eight months after tonsillectomy.
Erythrocyte sedimentation rate was 119mm/hr and C-reactive protein was 7.2mg/dl. Digital subtraction angiography showed narrowing of the left subclavian artery and slight narrowing of the upper part of the abdominal aorta and a part of the superior mesenteric artery. We, therefore, considered that vascular involvement associated with Behçet's disease (Vasculo-Behçet's disease) had developed and increased the dose of prednisolone up to 40mg/day. Subsequently, erythrocyte sedimentation rate and C-reactive protein were normalized and symptoms were relieved.
Considering the clinical course of the patient, tonsillectomy probably triggered vascular involvement of Behçet's disease. Much attention should be paid to the effects of tonsillectomy on the course of Behçet's disease.