用正子攝影證實一位可能為白塞氏症候群相關反覆假性動脈瘤的患者使用免疫抑制劑治療具有極佳療效的臨床驗證

Clinical evidence of a good response to immunosuppressant therapy in a case of possible Bechet's syndrome related recurrent pseudo-aneurysms demonstrated by positron emission tomography (PET)

A 21 year-old man who is a smoker for 1 package per day for 4 years presented with gradual onset right lower leg soreness and numbness for 2 months. Lower extremities computed tomography angiography (CTA) revealed right lower leg anterior tibial arterial (ATA) thrombosis and he received successful percutaneous transluminal angioplasty (PTA). But he had a recurrence of intermittent right calf pain, distal extremities cyanosis and claudication. The repeat CTA revealed occlusion of right ATA and a pseudo-aneurysm of right popliteal artery. He received successful PTA to ATA and symptom relieved. However, he suffered from re-occlusion of right femoral artery 5 months later. He received PTA to right superficial femoral artery (SFA) successfully. Unfortunately, the follow up CTA revealed pseudoaneurysm in M/3 of right SFA and left femoral artery (puncture site of previous PTA procedure). Finally, repeat PTA with stent placement in right SFA was performed successfully. Physical examination revealed pseudo-folliculitis over his chest, back and face. The ESR and hsCRP level were 45mm/hr (normal range: 0-10 mm/hr) and 6.57mg/dL (normal range:<0.3 mg/dL).