title: [Aortic inflammatory lesions in Behçet's disease].
abstract: The arterial lesions affect about 10% of patients with Behçet's disease (BD). Aortic inflammatory involvement includes predominantly aortic aneurysmal lesions affecting most often the abdominal aorta. They account for the severity of the disease and are a leading cause of death when they hit the aorta or pulmonary arteries. Within the arterial lesions of BD, aortic involvement is, with femoral lesions, the most common site involved (18-28% of patients with vascular disease). Unlike other large vessels vasculitis (i.e. giant cell arteritis and Takayasu's arteritis) diffuse aortitis is observed in less than 5% of patients with BD. Aortic lesions of BD may be asymptomatic (systematic imaging or occasionally associated with other vascular event) or be revealed by the occurrence of abdominal, thoracic or lumbar pain, or an aortic valve insufficiency. Fever is frequently associated. Increase in acute phase reactants is common in these patients. Histological analysis may show infiltration by lymphocytes, neutrophils and plasma cells in the media and adventitia and a proliferation of the vasa vasorum in the media as well as a fibroblastic proliferation. In the later phase, a fibrous thickening of the media and adventitia is observed as well as a proliferation and thickening of the vasa vasorum. The therapeutic management should always include a medical treatment for the control of inflammation (corticosteroids, immunosuppressive drugs and/or biotherapy) and often an endovascular or surgical treatment if the aneurysm is threatening. The choice between endovascular or surgical treatment is considered case by case, depending on the experience of the team, anatomical conditions and of the clinical presentation. In this review, we provide a detailed and updated review of the literature to describe the aortic inflammatory damage associated with Behçet's disease.
authors.affiliation: Service de médecine interne et d'immunologie clinique, Centre national de référence des maladies auto-immunes et systémiques rares, université Pierre-et-Marie-Curie, DHU i2B, inflammation, immunopathologie, biothérapie, groupe hospitalier Pitié-Salpêtrière, Assistance publique-Hôpitaux de Paris (AP-HP), Paris 6, 83, boulevard de l'Hôpital, 75013 Paris, France.
authors.forename: A-C
authors.initials: AC
authors.lastname: Desbois
authors.affiliation: Service de médecine interne et d'immunologie clinique, Centre national de référence des maladies auto-immunes et systémiques rares, université Pierre-et-Marie-Curie, DHU i2B, inflammation, immunopathologie, biothérapie, groupe hospitalier Pitié-Salpêtrière, Assistance publique-Hôpitaux de Paris (AP-HP), Paris 6, 83, boulevard de l'Hôpital, 75013 Paris, France.
authors.forename: B
authors.initials: B
authors.lastname: Wechsler
authors.affiliation: Service de médecine interne et d'immunologie clinique, Centre national de référence des maladies auto-immunes et systémiques rares, université Pierre-et-Marie-Curie, DHU i2B, inflammation, immunopathologie, biothérapie, groupe hospitalier Pitié-Salpêtrière, Assistance publique-Hôpitaux de Paris (AP-HP), Paris 6, 83, boulevard de l'Hôpital, 75013 Paris, France.
authors.forename: P
authors.initials: P
authors.lastname: Cacoub
authors.affiliation: Service de médecine interne et d'immunologie clinique, Centre national de référence des maladies auto-immunes et systémiques rares, université Pierre-et-Marie-Curie, DHU i2B, inflammation, immunopathologie, biothérapie, groupe hospitalier Pitié-Salpêtrière, Assistance publique-Hôpitaux de Paris (AP-HP), Paris 6, 83, boulevard de l'Hôpital, 75013 Paris, France. Electronic address: david.saadoun@aphp.fr.
authors.forename: D
authors.initials: D
authors.lastname: Saadoun
mesh_terms: D001014:Aortic Aneurysm / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy; D001025:Aortitis / Q000150:complications* / Q000000981:diagnostic imaging / Q000628:therapy; D001528:Behcet Syndrome / Q000150:complications* / Q000000981:diagnostic imaging / Q000628:therapy; D001691:Biological Therapy / Q000379:methods; D013700:Giant Cell Arteritis / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D013625:Takayasu Arteritis / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy
chemical_list: D007166:Immunosuppressive Agents
keywords: Angio-Behçet; Anévrysme aortique; Aortic aneurysm; Aortite; Aortitis; Behcet's disease; Biotherapy; Biothérapie; Immunosuppresseurs; Immunosuppressive drugs; Maladie de Behçet; Vascularite; Vasculitis