1. [Rapidly progressive aortic insufficiency in a female patient with rheumatoid arthritis].
- Author
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Mannaerts HF, May JF, Vierboom MA, and Hamer JP
- Subjects
- Adult, Aortic Valve Insufficiency blood, Aortic Valve Insufficiency surgery, Arthritis, Rheumatoid blood, Blood Sedimentation, C-Reactive Protein isolation & purification, Diagnosis, Differential, Endocarditis diagnosis, Female, Heart Valve Prosthesis, Humans, Rheumatoid Factor isolation & purification, Aortic Valve Insufficiency etiology, Arthritis, Rheumatoid complications
- Abstract
In a 23-year-old woman with severe rheumatoid arthritis, a rapidly progressive aortic regurgitation (onset within 2 years) was observed. She had a high IgM rheumatoid factor titre and nailfold lesions. The differential diagnosis from infectious endocarditis was difficult. The patient's aortic valve was replaced with a St. Jude mechanical prosthesis. The aortic valve was tricuspid with thick sclerotic cusps and sterile ulcerations and vegetations on the left and right coronary cusps. Histopathologic examination showed hyaline degenerative changes and plasma cell infiltrates in the stroma of the cusps, associated with rheumatoid arthritis. In the literature, aortic regurgitation is associated with longstanding rheumatoid arthritis, subcutaneous nodules, a high IgM rheumatoid factor titre and (or) signs of vasculitis.
- Published
- 1994