A case of Behçet’s disease associated with aortic regurgitation and nephrotic syndrome

Abstract

A 50-year-old housewife with chief complaint of dyspnea is reported. In 1975, the patient developed aphthous stomatitis, genital ulcers, uveitis and erythema nodosum, and was diagnosed as having Behçet’s disease at the Department of Dermatology of our hospital. Oral prednisolone was started in May 1985. Proteinuria was first detected in April 1987. The patient developed orthopnea in July 1992 and was admitted to our hospital in September of that year. Her past history revealed hyperlipidemia since January 1984 and a diagnosis of aortic regurgitation (AR) was made in 1984. Physical examination revealed a systolic/diastolic murmur in the chest and pretibial edema. Laboratory findings showed proteinuria (3.8 g/day) and hypoproteinemia. Microscopic findings of renal biopsy revealed mesangial proliferative glomerulonephritis and arteriosclerosis. Immunofluorescent studies demonstrated deposits of Apo B in the basement membrane and the mesangium. She was discharged from our hospital as proteinuria was decreased after combination treatment with camostat mesilate 600 mg/day and sairei-to 9.0 g/day. Hypertension and hyperlipidemia appeared to have acted as aggrevating factors for renal lesions caused by Behçet’s disease, so that our patient developed the nephrotic syndrome. We report a rare case of Behçet’s disease complicated by aortic regurgitation and the nephrotic syndrome.

Key words::

• aortic regurgitation
• Behçet’s disease
• hyperlipidemia
• nephrotic syndrome