title: A case of rheumatic valvular heart disease and autoimmune gastritis.
abstract: We present a case of a 50-year-old female patient with a history of depressive disorder and anaemia (attributed to menorrhagias). She was admitted to the cardiology department with symptoms of fatigue on moderate exertion for several months, with worsening in the month before hospitalisation. Echocardiography revealed a severe mitral stenosis of rheumatic aetiology. Laboratory tests showed microcytic and hypochromic anaemia, reduced iron stores and vitamin B12 levels, and positive serum antiparietal cells autoantibodies. Endoscopy showed focal areas of erythema in the stomach, corresponding histologically to chronic atrophic gastritis. In this context, two distinct clinical entities were diagnosed in the same patient: severe rheumatic mitral stenosis and autoimmune gastritis. The patient was started on vitamin B12 and iron supplementation and underwent surgical correction of the valvular disease. There was symptomatic improvement in her signs of fatigue.
authors.affiliation: Hospital Santarém, Santarém, Portugal.
authors.forename: Cátia
authors.initials: C
authors.lastname: Costa
authors.affiliation: Hospital Santarém, Santarém, Portugal.
authors.forename: David
authors.initials: D
authors.lastname: Durão
authors.affiliation: Hospital Santarém, Santarém, Portugal.
authors.forename: Marisa
authors.initials: M
authors.lastname: Peres
authors.affiliation: Hospital Santarém, Santarém, Portugal.
authors.forename: Margarida
authors.initials: M
authors.lastname: Leal
mesh_terms: D000740:Anemia / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology; D018798:Anemia, Iron-Deficiency / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy; D001323:Autoantibodies / Q000097:blood; D001327:Autoimmune Diseases / Q000097:blood / Q000150:complications / Q000175:diagnosis; D004452:Echocardiography; D005221:Fatigue / Q000097:blood / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology; D005260:Female; D005757:Gastritis, Atrophic / Q000097:blood / Q000175:diagnosis* / Q000473:pathology; D006801:Humans; D000090463:Iron Deficiencies; D019266:Iron, Dietary / Q000627:therapeutic use; D008875:Middle Aged; D008943:Mitral Valve / Q000000981:diagnostic imaging* / Q000601:surgery; D008946:Mitral Valve Stenosis / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery; D010295:Parietal Cells, Gastric; D012214:Rheumatic Heart Disease / Q000150:complications*; D013270:Stomach / Q000473:pathology*; D014805:Vitamin B 12 / Q000627:therapeutic use; D014806:Vitamin B 12 Deficiency / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology
chemical_list: D001323:Autoantibodies; D019266:Iron, Dietary; D014805:Vitamin B 12