[Primary aneurysm of the right common iliac artery]. / Anévrisme de l'artère iliaque primitive droite.

We here report the case of a 55-year old patient, with a history of recurrent buccal aphthosis, hospitalized for pelvic pain of sudden onset. Clinical examination showed sensitive pulsatile pelvic mass with blowing sound suggesting vascular origin. Examination of external genitalia showed scrotal scar after healing of aphthous ulcers. Laboratory test showed inflammatory syndrome with CRP levels of 80 mg/L, syphilis serological test was negative, doppler ultrasonography revealed primary aneurysm of the right common iliac artery and arteriography confirmed the diagnosis. The diagnosis of Behcet's disease was retained because of bipolar aphthosis and vascular involvement. Treatment was based on surgical resection of the aneurysm, bolus corticosteroids for three days, then oral corticosteroids and monthly intravenous cyclophosphamide infusion. Patient's outcome was favorable.

[Ruptured renal artery aneurysms in microscopic polyangiitis]. / Rupture d'anévrismes des artères rénales dans la polyangéite microscopique.

INTRODUCTION: Renal artery aneurysms are unusual manifestations of microscopic polyangiitis. OBSERVATION: We report the case of a 55 years old male patient, with a microscopic polyangiitis, which was revealed by a demyelinating polyradiculoneuropathy, the diagnosis was made with association of alveolar hemorrhage, peripheral neuropathy and glomerulonephritis with positive antineutrophil cytoplasmic antibodies (antimyeloperoxidase antibodies). The evolution was marked by a state of shock by rupture of aneurysms of intrarenal arteries. CONCLUSION: This case emphasizes the importance of looking for complications of unusual type of intrarenal aneurysms in patients with microscopic polyngiitis.

[Behcet syndrome: thirty comments with lung and vascular injury of peripheral vessels]. / Maladie de Behçet: trente observations avec atteintes vasculaires pulmonaires et des vaisseaux péripheriques.

INTRODUCTION: Behcet's disease is a systematic vasculitis of unknown cause, characterized essentially by eye, cutaneous, articular, neurological and vascular manifestations. METHODS: We retrospectively analysed the Behcet's disease cases that were followed up in our ward from January 2000 to January 2009. The inclusion criteria were those of International Study Group on Behçet's disease (aphthosis mouth was required). Data were retrieved and analysed with two softwares (Access(®) and Epi Info(®)). RESULTS: We observed 30 cases with vascular lesions on a series of 92 patients with Behcet's disease. Most patients were male, with an average age around 40. The venous manifestations, concerning essentially the lower limbs (deep and superficial thrombosis) were found at 27 patients (90 %), and the average of age during the appearance of the venous lesions was 40 years. Arterial lesions appear more late in 13 patients (43 %) (average of age 43 years). We noted, on the other hand, 11 cases of aneurysms and five cases of arterial thrombosis. The use of corticosteroids was necessary in all cases in association with the others drugs (anticoagulants, colchicine, immunosuppressors). Among the patients having had aneurysms, six were treated surgically. The outcome was favorable for most patients. Two patients had pulmonary embolism and two post-surgery complications. One patient died in the consequences of an intragastric break of an aneurysm of the abdominal aorta. CONCLUSION: The vascular involvement in Behcet's disease is manifested primarily by thrombophlebitis. Achieving blood pressure, less common, is problematic therapeutic because of the recurrent and life threatening.