Acute aortic insufficiency associated with Wegener granulomatosis.
Cardiac valvular involvement associated with Wegener granulomatosis is uncommon. We describe a 17-year-old male adolescent who sought medical attention because of a sore throat, arthralgias, low-grade fever, and fatigue of 3 weeks' duration. A rash was noted on his elbows, hands, and ankles; subsequently, a crusting lesion was noted in his internal nares, and infiltrates were detected on chest radiography. Blood cultures were negative for pathogens. An echocardiogram disclosed mild left ventricular enlargement with grade 2 aortic insufficiency, and Wegener granulomatosis was diagnosed based on an antineutrophil cytoplasmic antibody titer of 1:512. When blood cultures are negative for aortic valve endocarditis, a high index of clinical suspicion and antineutrophil cytoplasmic antibody testing may lead to the diagnosis of acute aortic insufficiency associated with Wegener granulomatosis.
Leff
R D
RD
Section of Rheumatology, St. Mary's/ Duluth Clinic Health System, Minn 55805, USA.
Hellman
R N
RN
Mullany
C J
CJ
D000208:Acute Disease; D000293:Adolescent; D019268:Antibodies, Antineutrophil Cytoplasmic / Q000097:blood*; D001022:Aortic Valve Insufficiency / Q000209:etiology* / Q000276:immunology; D003937:Diagnosis, Differential; D014890:Granulomatosis with Polyangiitis / Q000150:complications* / Q000175:diagnosis* / Q000276:immunology; D006801:Humans; D008297:Male
D019268:Antibodies, Antineutrophil Cytoplasmic