When rare matters: aortic valve destruction in myeloperoxidase antineutrophil cytoplasmic antibody–associated microscopic polyangiitis

Microscopic polyangiitis (MPA) is an ANCA-associated, pauci-immune necrotizing small-vessel vasculitis with multisystem involvement, most commonly renal, pulmonary, and cutaneous.Its clinical presentation is heterogeneous and often nonspecific, with constitutional symptoms such as fever, unintentional weight loss, and asthenia [1].We report the case of a 55-year-old woman with microscopic polyangiitis, diagnosed in October 2024 with the presence of strongly positive anti-myeloperoxidase antibodies (MPO-ANCA).