A 38-year-old male with abdominal pain which increased on walking was sent home with medications as no conditions were found on examination. After 2 weeks he returned with non-traumatic lower back pain with respect to the right thigh. Further examination revealed an increased swelling on the right thigh. The patient had a history of intermittent fever. The laboratory results were not significant; however, the ultrasound showed bilateral DVT in both the lower limbs that extended to both iliac veins and IVC. Subsequently the medical team carried out a bundle of investigations to exclude malignancies, TB, HIV, infections, and autoimmune diseases. CT of the abdomen and chest showed renal vein thrombosis indicating a putative prostatic infection. Also, MRI confirmed the IVC thrombosis. The urologist also seconded the opinion on the CT. In addition, the examination of the patient revealed scrotal ulcer.US, on the testes did not reveal any abnormality. Then, the patient was re-evaluated by the medical and rheumatology teams that found recurrent oral ulcers. The patient was not a smoker and had no medical history, but a history of recurrent oral and scrotal ulcer; a few acne- type lesions on his back.
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