A case of aortic and mitral valve involvement in granulomatosis with polyangiitis.
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| Abstract |
Granulomatosis with polyangiitis (GPA) (Wegener's) is a necrotizing systemic vasculitis of the small-sized blood vessels, affecting kidneys, lungs, upper respiratory tract and skin. Cardiac valvular involvement is an uncommon manifestation of GPA. We report the case of a 60-year-old woman with arthritis and lung nodules due to GPA without antineutrophil cytoplasmic antibodies (ANCA) at time of diagnosis. Remission was obtained with cyclophosphamide and corticosteroid. Azathioprine was then prescribed for 2years. Four years later, she developed severe inflammatory aortic and mitral valvular involvement characterized by GPA typical histopathological valvular lesions. Search for ANCA was positive at this time (anti-myeloperoxidase). Cardiac valvular involvement is a rare and potentially fatal complication of GPA and may misleadingly suggest infectious endocarditis. A review of literature revealed few cases of histologically well-documented cardiac valvular involvement in GPA. Pathologists should be aware of valvular heart diseases in GPA, which usually comprise valvular necrotic lesions without any microbial agents.
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| Authors | Olivier Espitia, Laure Droy, Sabine Pattier, Frédérique Naudin, Antoine Mugniot, Arnaud Cavailles, Mohamed Hamidou, Patrick Bruneval, Christian Agard, Claire Toquet |
| Journal | Cardiovascular pathology : the official journal of the Society for Cardiovascular Pathology (Cardiovasc Pathol) 2014 Nov-Dec Vol. 23 Issue 6 Pg. 363-5 ISSN: 1879-1336 [Electronic] United States |
| PMID | 25194969 (Publication Type: Case Reports, Journal Article, Review) |
| Copyright | Copyright © 2014 Elsevier Inc. All rights reserved. |
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