Progression of coronary disease in a Behcet’s patient in remission

Behcet’s disease is characterised histologically by vasculitis. In the heart this can lead to aneurysm formation and thrombosis. There is also accelerated atherosclerosis, the mechanism of which is unclear. Patients with external disease from Behcet’s disease are treated with immunosuppression. The authors present a case of aneurysmal disease in a Behcet’s patient. This case demonstrates that coronary disease may progress in Behcet’s patients despite external disease remission. Therefore, internal disease may progress in the absence of external symptoms when immunosuppressive therapy is usually stopped. This case raises the issue of whether immunosuppression should be continued in Behcet’s patients with coronary disease to suppress disease progression or included in a treatment protocol for patients with Behcet’s related coronary disease. Clinical trials on the use of immunosuppressive therapy for coronary disease in Behcet’s patients are needed.