Barw Barw Medical Journal 2960-1959 2023 12 10 Co-Occurrence of Behçet's Disease and Ankylosing Spondylitis: A Rare Case Report 10.58742/ae394w82 eng Soran Mohammed Gharib Shar Hospital, Department of Rheumatology, Sulaimani, Kurdistan, Iraq. soran.gharib@gmail.com Hemin S. Mohammed Smart Health Tower, Madam Mittrand, Sulaimani, Kurdistan, Iraq. hemin.mohammed@gmail.com Abdullah Kamal Ghafour Smart Health Tower, Madam Mittrand, Sulaimani, Kurdistan, Iraq. abdullah.ghafour@gmail.com Karokh Fadhil Hama Hussein Gastroenterology and Hepatology Teaching Hospital, Sulaimani, Kurdistan, Iraq . karokh12@gmail.com Jihad Ibrahim Hama Research Center, University of Halabja, Halabja, Kurdistan, Iraq. jihad.hama@gmail.com Abdullah Abdulrahman Qadir College of Medicine, University of Sulaimani, Sulaimani, Kurdistan, Iraq. abdullah.qadir@gmail.com 2023 11 01 Abstract Introduction Behçet's Disease and Ankylosing Spondylitis are two distinct inflammatory conditions that have rarely been reported to coexist. This study reports a 41-year-old male patient with the co-occurrence of both conditions. Case presentation A 41-year-old male presented with chronic lower back pain for a period of 20 years. He also had left eye redness and painful oral ulcers. On physical examination, there were oral lesions and left eye redness (uveitis), and the patient's spine exhibited restricted mobility. Magnetic Resonance Imaging of the sacroiliac joint showed sacroiliacis affecting both sacroiliac joints. Hence, the patient was diagnosed as a case of mixed Behcet's disease and ankylosing spondylitis. The patient was managed with Azathioprine (Imuran) tablet (50 mg) twice daily, Colchicine tablet (1 mg) once daily, Topical steroid and Ulciguard mouth spray, Prednisolone tablet (5 mg) once daily, calcium and vitamin D3 tablet once daily, steroid eye drops, nonsteroidal anti-inflammatory drugs for 2 weeks. As a result, the patient achieved a dramatic response with all the symptoms resolved. Conclusion Behçet's disease and ankylosing spondylitis can coexist with overlapping presentations, making their clinical diagnosis challenging.