Calf Pain as a Prominent Feature of Behçet's Disease

Abstract

Objective. This study aimed to present four cases of Behçet's disease (BD) wherein recurrent calf pain was the first and prominent symptom experienced by the patients.

Methodology. The case series described the clinical features, disease development, management, and outcomes of these patients. Written consent was obtained from each participant for the review and publication of their case.

Results. All cases presented with chronic and recurrent calf pain, three of whom were bilateral. All four had skin changes on the lower extremities that may have contributed to leg pain. Only probing was a history of oral ulcers reported in all four; none had genital ulcers, eye abnormality, or sensory or motor deficits. All presented with elevated acute phase reactants. Based on the 2013 International Criteria for Behçet’s Disease (ICBD), a diagnosis of possible BD was made due to the presence of oral ulcers, skin lesions, and absence of other findings pointing to another connective tissue disease or systemic vasculitides. All four cases were given oral corticosteroids and colchicine, but two required the addition of methotrexate and azathioprine for control of symptoms.

Conclusion. A complaint of recurrent calf pain warrants inquiry and examination of the skin lesions over the affected area and other areas like the oral cavity and genital area. It also warrants consideration of a vasculitic process, especially in the background of oral ulcers and skin changes. In such cases, BD is the right differential diagnosis to be considered.