Death due to behcet's disease? Malpractice?

Abstract

Behcet's syndrome (BS) is a chronic disease characterized by the presence oral and genital ulcers, skin, eye, gastrointestinal, vascular, and central nervous system involvement; the etiology of the disease is not fully understood. While it is known to be frequent in Mediterranean countries, the highest prevalence is in Turkey. In BS, various types of vascular involvement are identifiable. BS generally leads to venous thrombosis with more frequent involvement at lower extremities, and majority of cases are men. While thrombophlebitis is often observed, thromboembolic diseases are rarely found, because the venous thrombi adhere to the walls of the veins tightly.Our case is a 19-year-old male who developed massive hemoptysis in his sister's house where he was visiting for vacation and was brought to the hospital by emergency service. Despite aggressive cardiopulmonary resuscitation the patient deceased. His was classified as suspicious and the patient transferred to our service for autopsy. Upon reviewing the hospital documents we found that he was followed up for BS for about two years, and was treated with anticoagulants for pulmonary embolism in the last 5 months after being admitted in a chest clinic for hemoptysis. During external examination in bloody foams were detected in the mouth and nose. During the internal examination we found a pulmonary artery aneurism of 6 cm in diameter with a thrombus inside, a 20 cm long thrombus that was blocking almost the whole lumen of the popliteal vein and a macroscopic infarct and blood aspiration areas in the left lung.We discuss the autopsy findings of this case along with the literature in this field.