Vasculo-Behçet disease complicated by conversion disorder diagnosed with 18 F-fluoro-deoxy-glucose positron emission tomography combined with computed tomography (PET/CT)

Vasculitis in Behçet's disease, termed "vasculo-Behçet's disease," is a major cause of mortality and morbidity. We report a case of vasculo-Behçet's disease complicated by conversion disorder, in which F-fluoro-deoxy-glucose positron emission tomography combined with compute...

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Bibliographic Details
Published inFukushima journal of medical science Vol. 65; no. 2; p. 55
Main Authors Furuya, Makiko Yashiro, Temmoku, Jumpei, Fujita, Yuya, Matsuoka, Naoki, Asano, Tomoyuki, Sato, Shuzo, Kobayashi, Hiroko, Watanabe, Hiroshi, Migita, Kiyoshi
Format Journal Article
LanguageEnglish
Published Japan 30.08.2019
Subjects
Adult
Behcet Syndrome - diagnostic imaging
Conversion Disorder - complications
Female
Fluorodeoxyglucose F18
Humans
Positron Emission Tomography Computed Tomography - methods
Radiopharmaceuticals
Vasculitis - diagnostic imaging
Conversion disorder
PET/CT
Vasculo-Behçet’s disease
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Summary:Vasculitis in Behçet's disease, termed "vasculo-Behçet's disease," is a major cause of mortality and morbidity. We report a case of vasculo-Behçet's disease complicated by conversion disorder, in which F-fluoro-deoxy-glucose positron emission tomography combined with computed tomography (FDG PET/CT) was useful for the diagnosis. A twenty-two-year-old woman recently diagnosed with tonsillitis presented with fever, right foot pain, left equinovarus foot, and numbness in both hands and feet. Laboratory data showed elevated levels of c-reactive protein (CRP). The patient was positive for HLA B51; pathergy testing was also positive. Nerve conduction velocity and electromyography were normal. MRI showed swelling of the left crural muscle group. PET/CT showed intense FDG uptake in the left popliteal artery, demonstrating active vasculitis. The patient was diagnosed with vasculo-Behçet's disease and treated with corticosteroids, colchicine, and infliximab, which led to obvious improvement of the MRI findings and reduction in CRP. However, left equinovarus foot and numbness in the extremities persisted. She also developed aphonia. They were attributed to psychogenic dystonia and conversion disorder, and psychiatric treatment was effective in relieving those symptoms. We suggest that PET/CT may be useful for the early diagnosis of medium-sized vessel vasculitis in patients with Behçet's disease.
ISSN:2185-4610