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Cyclosporine-induced pericarditis: an elusive cause of chest pain in Behçet’s disease

Behçet’s disease (BD) is a variable-vessel vasculitis which commonly presents with recurrent orogenital ulceration, skin lesions, visual disturbances and neurodeficits. Arterial involvement is seen variably in 8%–18% cases of BD, with common affliction of the carotid, pulmonary, aortic and iliofemoral arteries. Cardiac involvement in the form of myocarditis, myocardial infarction, pericarditis, cardiac dysrhythmias or valvular disease is also known in BD, although rarely. Sudden-onset chest pain in BD is a medical emergency, with acute coronary syndrome, pulmonary thromboembolism and rupture of aortic or pulmonary artery aneurysms being the commonly implicated causes. Here, we report a rare case of BD who presented with sudden-onset severe chest pain, the cause of which remained elusive despite extensive evaluation for the abovementioned causes. To the best of our knowledge, this is the first reported case of cyclosporine-induced pericarditis in BD in available literature and should be considered in patients on cyclosporine presenting with chest pain.