Reimer K A, Rodgers R F, Oyasu R
JAMA. 1976 Jun 7;235(23k0):2510-2. doi: 10.1001/jama.235.23.2510.
Aortic insufficiency and aortitis are frequent complications of ankylosing spondylitis but are considered rare in rheumatoid arthritis. A 49-year-old woman with severe rheumatoid arthritis had the cardiovascular changes common to both diseases. At autopsy, the heart and aorta showed granulomatous ane fibrinous pericarditis and epicarditis, "core" granulomas in the aortic valve cusps and mitral valve leaflets, and coronary arteritis. These are considered to be classical changes of rheumatoid carditis. In addition, there were mesoaortitis with obliterative endarteritis of the vasa vasorum and fibrosis of the aortic cusps with separation of the commissures. These are considered to be changes of ankylosing spondylitis. This case, therefore, represents a mixed form of cardiovascular involvement within the spectrum of the rheumatoid diseases.
主动脉瓣关闭不全和主动脉炎是强直性脊柱炎的常见并发症，但在类风湿关节炎中被认为罕见。一名49岁患有严重类风湿关节炎的女性出现了这两种疾病共有的心血管变化。尸检时，心脏和主动脉显示有肉芽肿性和纤维蛋白性心包炎及心外膜炎、主动脉瓣叶和二尖瓣叶的“核心”肉芽肿以及冠状动脉炎。这些被认为是类风湿性心脏病的典型变化。此外，存在中主动脉炎伴滋养血管闭塞性动脉内膜炎以及主动脉瓣叶纤维化伴瓣叶连合分离。这些被认为是强直性脊柱炎的变化。因此，该病例代表了类风湿疾病范围内心血管受累的一种混合形式。
