title: Bronchial artery enlargement may be the cause of recurrent haemoptysis in Behçet's syndrome patients with pulmonary artery involvement during follow-up.
abstract: OBJECTIVE
  Haemoptysis occurring in a Behçet's syndrome (BS) patient with pulmonary artery involvement (PAI) during follow-up is usually regarded as PAI relapse. However, bronchial artery enlargement (BAE) may be the source of haemoptysis in some patients.
  
  
  METHODS
  A chart review at the end of December 2014 revealed 118 patients with PAI in our centre since 1979. Nine (all men) had recurrent haemoptysis during follow-up which could not be explained with relapse of PAI.
  
  
  RESULTS
  Haemoptysis recurred a median of 1.5 years (IQR: 9 months-5 years) during follow-up. Thorax CT scans did not show relapse of PAI or emergence of BAE. The patients were treated empirically but continued to complain of occasional haemoptysis thereafter. BAE was detected in 8 patients after a median follow-up of 9 years (IQR: 5-12 years). Six patients underwent bronchial artery embolisation that was repeated in 3. One patient with severe pulmonary hypertension died 3 weeks later. The remaining 5 are under follow-up for between 5 months-9 years. Pulmonary infarction and mild hemiparesis occurred in 2 patients after embolisation. One patient died with haemoptysis before undergoing embolisation. Another one with small BAE is under follow-up for 8 years without embolisation. The source of bleeding could not be determined in 1 patient who is now haemoptysis free for 5 years.
  
  
  CONCLUSIONS
  BAE may be the source of recurring and fatal haemoptysis in BS patients with PAI during follow-up. Embolisation appears to be a life-saving procedure.
authors: Department of Internal Medicine, Division of Rheumatology, Istanbul University, Cerrahpasa Medical School, Istanbul, Turkey.
authors: Sinem Nihal
authors: SN
authors: Esatoglu
authors: Department of Internal Medicine, Division of Rheumatology, Istanbul University, Cerrahpasa Medical School, Istanbul, Turkey.
authors: Emire
authors: E
authors: Seyahi
authors: Department of Internal Medicine, Division of Rheumatology, Istanbul University, Cerrahpasa Medical School, Istanbul, Turkey.
authors: Serdal
authors: S
authors: Ugurlu
authors: Department of Radiology, Istanbul University, Cerrahpasa Medical Faculty, Istanbul, Turkey.
authors: Fatih
authors: F
authors: Gulsen
authors: Department of Radiology, Istanbul University, Cerrahpasa Medical Faculty, Istanbul, Turkey.
authors: Canan
authors: C
authors: Akman
authors: Department of Radiology, Istanbul University, Cerrahpasa Medical Faculty, Istanbul, Turkey.
authors: Murat
authors: M
authors: Cantasdemir
authors: Department of Radiology, Istanbul University, Cerrahpasa Medical Faculty, Istanbul, Turkey.
authors: Furuzan
authors: F
authors: Numan
authors: Department of Cardiovascular Surgery, Istanbul University, Cerrahpasa Medical Faculty, Istanbul, Turkey.
authors: Hasan
authors: H
authors: Tuzun
authors: Department of Internal Medicine, Division of Rheumatology, Istanbul University, Cerrahpasa Medical School, Istanbul, Turkey.
authors: Melike
authors: M
authors: Melikoglu
authors: Department of Internal Medicine, Division of Rheumatology, Istanbul University, Cerrahpasa Medical School, Istanbul, Turkey.
authors: Hasan
authors: H
authors: Yazici
authors: Department of Internal Medicine, Division of Rheumatology, Istanbul University, Cerrahpasa Medical School, Istanbul, Turkey. vhamuryudan@yahoo.com.
authors: Vedat
authors: V
authors: Hamuryudan
mesh_terms: D000293:Adolescent; D000328:Adult; D000783:Aneurysm / Q000000981:diagnostic imaging / Q000209:etiology*; D001157:Arterial Occlusive Diseases / Q000000981:diagnostic imaging / Q000209:etiology*; D001158:Arteries / Q000000981:diagnostic imaging; D001528:Behcet Syndrome / Q000150:complications* / Q000000981:diagnostic imaging; D001980:Bronchi / Q000098:blood supply*; D000072226:Computed Tomography Angiography; D004621:Embolization, Therapeutic; D006469:Hemoptysis / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D006801:Humans; D008297:Male; D008499:Medical Records; D011651:Pulmonary Artery / Q000000981:diagnostic imaging; D012008:Recurrence; D012189:Retrospective Studies; D012307:Risk Factors; D013927:Thrombosis / Q000000981:diagnostic imaging / Q000209:etiology*; D013997:Time Factors; D016896:Treatment Outcome; D014421:Turkey; D055815:Young Adult