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Titre

Retinal vasculitis: a challenging case

But	To report a diagnostic pitfall in a case of retinal vasculitis Methods: Observational report of a Caucasian male diagnosed as Behçet’s disease (BD), presenting with a branch retinal artery occlusion.
Méthodes	Observational report of a Caucasian male diagnosed as Behçet’s disease (BD), presenting with a branch retinal artery occlusion.
Résultats	A 25-year-old man presented with unilateral vision loss. He presented with a trace of cells, a superior branch retinal artery occlusion, vasculitis and macular edema. In his antecedents he reported a deep vein thrombosis (DVT), the presence of pretibial subcutaneous nodules and positive genotyping of B51. BD was diagnosed. Although suggestive, the criteria for BD were not fulfilled. The ocular arterial occlusion with low grade inflammation, the history of orchitis, the normal renal function, the negative ANCA’s and the biopsy proven cutaneous vasculitis of medium-sized arteries, fit well with the diagnosis of PAN. The treatment is based on the use of systemic steroids and immunosuppressants, primarily azathioprine. However, some cases are refractory to this treatment and respond well to biologics.
Conclusion	PAN is a necrotizing vasculitis of medium-sized arteries. BD is a systemic vasculitis that involves arteries and veins of any size. The diagnosis of BD is only supported by clinical criteria. Although HLA-B51 is a strongly associated risk factor for BD, there are no pathognomonic laboratorial findings of BD. Ocular vasculitic syndromes require a multidisciplinary approach and the exclusion of other diagnoses based on clinical presentation.
Conflit d'intérêt	Non

Auteur 1

Nom	JADNANANSING
Initiales	A
Institut	Faculty of Medicine, Ghent University
Ville	Ghent

Auteur 2

Nom	TERRYN
Initiales	W
Institut	Department of Nephrology, Jan Yperman Hospital
Ville	Ieper

Auteur 3

Nom	STOCKMAN
Initiales	A
Institut	Department of Dermatology, AZ Delta Hospital
Ville	Roeselare

Auteur 4

Nom	DE SCHRYVER
Initiales	I
Institut	Department of Ophthalmology, Ghent University Hospital
Ville	Ghent