Key result
Mitral valve histopathology in ankylosing spondylitis reveals chronic fibroinflammatory thickening, validating autoimmune involvement.
Why the study?
Mitral valve disease is observed in rare cases of ankylosing spondylitis, but the extent and mechanism of this involvement remain unclear.
Case Report (n=1)
Histopathologic analysis of an excised mitral valve in a patient with ankylosing spondylitis revealed chronic fibroinflammatory thickening, suggesting an autoimmune mechanism for mitral valve disease in this population.
Histologically validated mitral valve disease in ankylosing spondylitis warrants clinical consideration; leaves open prevalence and mechanisms.
Background: Ankylosing spondylitis (AS) is a chronic inflammatory disease of primarily the joints of the spine. In the literature, AS is known to have cardiac manifestations. Most frequently, this is aortic regurgitation. However, in rare cases also mitral valve (MV) disease is observed in AS patients. The extent and mechanism of this involvement are still unclear. We aim to describe a histologically validated case report to add understanding on this topic. Case summary: We show the case of a 51-year-old male who suffered since his youth from back pain and uveitis, which was later diagnosed as AS. After a first presentation with combined heart valve disease, the patient recovered on cardiac medical therapy and biologic treatment for AS. Four years later, cardiac complaints worsened mainly due to severe MV stenosis. Surgical treatment was performed with histopathologic analysis of the excised MV validating involvement of AS. Discussion: Histopathologic analysis showed chronic fibro inflammatory thickening of the MV leaflets and subvalvular apparatus. These pathological features could fit with the inflammatory nature of AS. Since this is a rare case, the recognition of fibro inflammatory thickening leading to commissural fusion and stenosis may contribute to better understanding of heart valve disease in AS to create a base for better cardiac management in this specific patient group.
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Mathari et al. (2022) conducted a case report in Ankylosing spondylitis with mitral valve disease (n=1). Ankylosing spondylitis was evaluated on Histopathologic analysis of the excised mitral valve. In a 51-year-old male with ankylosing spondylitis, histopathologic analysis of the excised mitral valve showed chronic fibroinflammatory thickening, validating autoimmune involvement.
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