Complete heart block in a Caucasian woman with Behçet's disease: a case report.
BACKGROUND
Behçet's disease is a progressive diffuse inflammatory vasculitis characterized by recurrent oral and genital ulceration and ocular inflammation. Cardiac involvement is a rare but well-documented manifestation of Behçet's disease. Complete heart block in non-Caucasian populations has been reported previously; however, in this report, we describe a unique case of complete heart block in a Caucasian woman with Behçet's disease.


METHODS
A 48-year-old Caucasian woman presented to our hospital with symptomatic complete heart block requiring a pacemaker implant on a background of recurrent oral and genital ulcers and oligoarthritis of 10 months' duration. She also had a history of recurrent diarrhea with a single episode of ocular inflammation in the recent past. She had no evidence of cardiac ischemia, and her autoimmune antibodies were within normal ranges. She was diagnosed with Behçet's disease according to international study group criteria and was commenced on prednisolone and sulfasalazine, to which she responded very well.


CONCLUSIONS
Cardiac complications should be considered when making a diagnosis of Behçet's disease, even in Caucasian patients. While mucocutaneous ulceration is indeed the most common manifestation of Behçet's disease, cardiovascular involvement tends to cause the most morbidity and mortality.
Department of Medicine, Lyell McEwin Hospital, Elizabeth Vale, SA, 5112, Australia. drsabeehurrehman@yahoo.com.|Present Address: Ballarat Base Hospital, Drummond Street North, Ballarat Central, VIC, 3350, Australia. drsabeehurrehman@yahoo.com.
Sabeeh-Ur-Rehman
SU
Butt
Department of Rheumatology, Modbury Hospital, Modbury, SA, 5092, Australia.
Julian
J
McNeil
D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D001528:Behcet Syndrome / Q000150:complications*; D004562:Electrocardiography; D005260:Female; D006327:Heart Block / Q000175:diagnosis / Q000209:etiology*; D006801:Humans; D008875:Middle Aged; D011239:Prednisolone / Q000627:therapeutic use; D012460:Sulfasalazine / Q000627:therapeutic use
D000893:Anti-Inflammatory Agents; D012460:Sulfasalazine; D011239:Prednisolone
Behçet’s disease; Caucasian; Female; Heart block