Behçet’s Disease-related Budd–Chiari Syndrome Successfully Managed with anti-TNF Antibody: A Case Report and Review of the Literature

Behçet’s disease (BD) is multisystemic vasculitis with heterogeneous clinical manifestations. We describe the case of a 26-year-old man who presented with Budd–Chiari syndrome (BCS) related to BD. The patient received infliximab (IFX) due to the severity of vascular involvement. Subsequently, after IFX therapy, hospital-acquired pneumonia, trapped lung, and fungal infection of the lung and central nervous system developed as complications. The patient benefited from a second course of IFX and clinical remission was achieved following early identification and treatment of complications. Data on the presentation and prognosis of BCS related to BD are extremely limited. Our case report supports the growing evidence that anti-TNF antibody is a promising treatment for BD-related BCS. LEARNING POINTS: Behçet’s disease-related Budd–Chiari syndrome is a rare form of vascular involvement that severely affects mortality. Behçet’s disease-related Budd–Chiari syndrome is frequently confused with idiopathic thrombosis and may be underdiagnosed. Infliximab could be a therapeutic option for refractory Behçet’s disease with major vascular involvement, but the increased risk of opportunistic infections should be kept in mind.