Mitral valve prolapse in young healthy individuals. An early index of autoimmunity?

Abstract

Mitral valve prolapse (MVP) is a benign valvular abnormality. However, an increased prevalence of MVP is reported in patients with systemic lupus erythematosus and autoimmune thyroid disease. Our aim was to evaluate whether the presence of MVP in healthy individuals might indicate a premature index of subclinical autoimmune disorder. A total of 75 individuals with MVP and 44 individuals without MVP were identified by echocardiography. Serum samples were examined for various organ and non-organ specific autoantibodies. In all, 35 of the 75 individuals with MVP had at least one autoantibody. ANA were detected in 17/75 in MVP(+) versus 1/44 in the MVP(-), (P < 0.05), and anti-ENA in 6/75 in the MVP(+) versus 0/44 in the control group, P = ns. In the MVP(+) group, thyroid autoantibodies, IgA and IgG RF were found at a statistically significant higher incidence, 16/75, 11/75 and 10/75 versus 1/44, 0/44 and 0/44 in the MVP(-)group, respectively (P < 0.05). The levels of IgG anticardiolipin antibodies were significantly higher in the MVP(+) group, P < 0.05. The presence of organ and non-organ specific autoantibodies in young healthy MVP(+) individuals insinuate the presence of subclinical autoimmunity and might suggest that autoimmune mechanisms might be involved in its pathogenesis. A follow-up of these individuals might elucidate whether MVP constitutes an early index of autoimmunity.

Investigation of autoimmune diseases accompanying Hashimoto’s thyroiditis in children and adolescents and evaluation of cardiac signs

“…These high rates may be due to differences in the patient selection. Unlike in our study, some patients in other studies in the literature were found to be euthyroid, subclinical, and with no signs of Hashimoto's thyroiditis in the ultrasonography (7,8,16,17). Another difference between the ratios originated from patient population of the study.…”

“…Apart from hereditary connective tissue diseases, it was mostly related to autoimmune thyroid disease excluding. It was reported that MVP was frequent in both Graves' disease and Hashimoto's disease, and other markers of autoimmunity were also found to be increased in patients with MVP in addition to autoimmune thyroid disease (7,8,(14)(15)(16). Evangelopoulous et al reported in 1999 that they diagnosed MVP in eight out of 29 (28%) adult patients with Graves' disease, and in eight out of 35 (23%) patients with Hashimoto's thyroiditis, but there was no MVP in the control group.…”

“…Anti-TPO, anti-thyroid peroxidase; Anti-Tg, anti-thyroglobulin; ANA, anti-nuclear antibody. connective tissue diseases and autoimmune thyroid diseases (1,7,8,14). Apart from hereditary connective tissue diseases, it was mostly related to autoimmune thyroid disease excluding.…”

“…Some studies have reported that the incidence of MVP is high in familial connective tissue diseases and autoimmune thyroid diseases. A concomitance rate of Hashimoto's thyroiditis and MVP was found to be high in adult studies when compared with Brought to you by | University of Queensland -UQ Library Authenticated Download Date | 8/16/15 4:45 PM a fewer number of pediatric studies (5)(6)(7)(8). In the present study, it was aimed to investigate the concomitance of additional cardiac problems, mainly MVP, in adolescents and pediatric patients with Hashimoto's thyroiditis, by screening autoimmune markers.…”

Evaluation of Autoimmune Thyroid Disease in Patients with Mitral Valve Prolapse

“…Thus, they concluded that patients with MVP may have a higher autoimmune disease incidence because both diseases have similar family characteristics and are associated with tissue antigens, including HLA-D3, BW35, and A3. In another study by Evangelopoulos et al (20), the immunological parameters were investigated in patients with autoimmune thyroid diseases, and the association between MVP and autoimmune diseases (22). In 29 patients with Graves' disease, nine had MVP, whereas none of the controls had MVP (p<0.05).…”