Occult Multiple Arterial Occlusions in Behçet's Disease Manifesting as Posterior Reversible Encephalopathy Syndrome Secondary to Renovascular Hypertension.

Behçet's disease is a systemic vasculitis that can cause life-threatening complications. We report the case of a 28-year-old man with Behçet's disease who developed severe hypertension and generalized seizures. Imaging revealed concurrent complete occlusions of the left renal and common carotid arteries, with segmental infarction of the right kidney. Renal vasculature involvement caused marked hyperreninemia and renovascular hypertension, subsequently triggering posterior reversible encephalopathy syndrome. Treatment with high-dose glucocorticoids, cyclophosphamide, and strict blood pressure control resulted in clinical and neuroimaging resolution. This case illustrates that Behçet's disease can manifest as occult, multivessel arterial occlusions. Early systemic vascular screening and prompt immunosuppression are pivotal for preventing irreversible complications.