Thoracic Manifestations of Behçet’s Disease Excluding Cardiac Involvement: A 17-Year Retrospective Study in a Moroccan Tertiary Referral Center

Abstract

Background: Thoracic involvement in Behçet’s disease (BD) is uncommon but is associated with significant morbidity and mortality, mainly due to vascular complications. Aim: This study aimed to evaluate thoracic manifestations of Behçet’s disease, excluding cardiac involvement, in patients managed at a Moroccan tertiary hospital over a 17-year period. Methods: This retrospective single-centre study was conducted over a 17-year period (2006–2023) in the Internal Medicine Department of Ibn Rochd University Hospital, Casablanca, Morocco. Among 563 patients diagnosed with BD according to the International Study Group (1990) criteria and the International Criteria for Behçet’s Disease (2013), 58 patients presented with thoracic manifestations excluding cardiac involvement. Results: Thoracic involvement was observed in 10.3% of cases. The mean age was 35.3 ± 10.9 years, with a male predominance (M/F ratio = 2). Haemoptysis was the most frequent symptom (44.8%). CT angiography revealed pulmonary artery aneurysms in 32.7%, pulmonary embolism in 37.9%, and superior vena cava thrombosis in 15.5%. Treatment was based on corticosteroids and immunosuppressants. The clinical course was favourable in most patients after treatment, with regression of symptoms and stabilisation of vascular lesions. However, relapses occurred in some cases, reflecting the chronic relapsing nature of the disease. Mortality was mainly related to massive haemoptysis secondary to aneurysmal rupture. Conclusion: Thoracic manifestations of BD are predominantly vascular and determine prognosis. Early diagnosis and intensive immunosuppressive therapy are essential to improve outcomes.