YU.V. POLYANSKIKH¹, A.M. MUKHITDINOVA¹, D.I. ABDULGANIEVA¹, E.V. SUKHORUKOVA², S.A. LAPSHINA1, N.G. SHAMSUTDINOVA¹

 ¹Kazan State Medical University, Kazan

²Republic Clinical Hospital, Kazan

  Contact details:

Polyanskikh Yu.V. — resident doctor of the Department of Hospital Therapy

Address: 49 Butlerov St., Kazan, Russian Federation, 420012, tel.: +7-950-168-99-77, e-mail: polyanskih.julya@yandex.ru

 The article presents a clinical case of a 27-year-old woman with infectious endocarditis in vasculitis associated with antineutrophil cytoplasmic antibodies. Difficulties in the management of the patient are described, consisting in verifying the nature of changes in the heart (vegetation), as well as in determining the treatment tactics. Changes in the heart were regarded as infectious endocarditis. Adequate antibacterial therapy was carried out with a positive clinical and laboratory effect, with a significant decrease in vegetations on the valves, a decrease in the size of the formation in the aorta sinus, and a decrease in aortic regurgitation. The therapy of infectious endocarditis in granulomatosis with polyangiitis is difficult due to the need for a correct combination of adequate antibacterial therapy of infectious endocarditis and high doses of glucocorticosteroids and immunosuppressive drugs for autoimmune disease.

Key words: Wegener’s granulomatosis, infectious endocarditis, antibacterial therapy.

REFERENCES

1. Richard A Watts 1, Suzanne Lane, David G I Scott. What is known about the epidemiology of the vasculitides? Best Pract Res Clin Rheumatol, 2005, vol. 19 (2), pp. 191–207. DOI: 10.1016/j.berh.2004.11.006
2. Życińska K., Borowiec A., Zielonka T.M. Echocardiographic Assessment in Patients with Granulomatosis with Polyangiitis. Adv Exp Med Biol, 2017, vol. 1022, pp. 27–33. DOI: 10.1007/5584_2017_43
3. Uijtterhaegen G., de Donder L., Ameloot E., Lefebvre K. Aortic valve replacement due to granulomatosis with polyangiitis: a case series. Eur Heart J Case Rep, 2020, vol. 4 (5), pp. 1–6. DOI: 10.1093/ehjcr/ytaa307
4. Taranova M., Strizhakov L., Androsova T. et al. A rare thromboembolic complication of infective endocarditis in a young patient with granulomatosis with polyangiitis (Wegener). Vrach, 2015, no. 8, pp. 58–62 (in Russ.).
5. Klinicheskie rekomendatsii: infektsionnyy endokardit i infektsiya vnutriserdechnykh ustroystv [Clinical guidelines: infective endocarditis and infection of intracardiac devices], 2021. P. 10.
6. Ibrahim Koral Onal, Levent Ozçakar, Kudret Temirel. Fatal endocarditis in Wegener’s granulomatosis: mitral valve involvement and an intracardiac mass. Joint Bone Spine, 2005 De., pp. 585–587. DOI: 10.1016/j.jbspin.2005.04.001