Aortic valve disease as a first manifestation of Alcaptonuria in surgical treated patient. Case report
Mile Vranes 1,2, Ilija Bilbija 1,2, Aleksandar Mikic 1,2, Natasa Kovacevic-Kostic 3, Radmila Karan 3, Dejan Nikolic 1,4, Biljana Obrenovic-Kircanski 1,5, Milos Velinovic 1,2
Affiliations
Article Info
1 Faculty of Medicine, University of Belgrade, Serbia
2 Clinic for Cardiar Surgery, Clinical Center of Serbia, Belgrade, Serbia
3 Center for Anesthesiology, Clinical Center of Serbia, Belgrade,Serbia
4 Physical Medicine and Rehabilitation Department, University Children’s Hospital, Belgrade, Serbia
5 Clinic for Cardiology, Clinical Center of Serbia, Belgrade, Serbia
Abstract
BACKGROUND: Alcaptonuria, a rare metabolic disorder (1:250 000), is usually presented with symptoms such as arthropathies of weight bearing joints. CASE REPORT: In this case, a 65 year old woman was admitted to our hospital with severe aortic stenosis and no other symptoms that would suggest the existance of Alcaptonuria. Intraoperative findings of black discoloration of the affected valve and ascending aorta, pointed towards the diagnosis of cardiac ochronosis, what was then confirmed by a PH examination. CONCLUSION: This case suggests that although alcaptonuria is a slow progressive disease with cardiac ochronosis as a predictable late complication, it can nevertheless be a first sign. In that case the attention should be brought to the surely affected lumbar spine and weight bearing joints, and other connective tissue.
Keywords
- Alcaptonuria
- Aortic valve
- Cardiac ochronosis
- Surgery