Abstract

The paper describes the case of a patient affected by a combination of genetic and autoimmune diseases (multiple sclerosis, psoriatic arthritis, Leiden V mutation, and sicca syndrome) and hypertension. The psoriatic arthritis was treated with celecoxib and multiple sclerosis with fingolimod. The patient developed high fever and endocarditis, resulting in severe mitral regurgitation, atrial fibrillation, and congestive heart failure. Evidence is suggestive of adverse effects of potent immunosuppressive and anti-inflammatory therapies with biologic agents and the cardiovascular system. Fingolimod increases susceptibility to infections and induced endocarditis resulting in severe mitral regurgitation, atrial fibrillation, and congestive heart failure. Managed care systems limit the contact among basic care physicians and specialists. However, the process by which the optimal decision may be reached for a patient with a complex pathology is shared decision making, where the risk of severe complications and medical expenses may be reduced.

Links

Publisher Full Text

Authors

Cocco G

Institution

Cardiology Office, Marktgasse 10A, 4310 Rheinfelden, Switzerland. praxis@cocco.ch

Source

Cardiovascular toxicology 12:3 2012 Sep pg 266-72

MeSH

Arthritis, Psoriatic
Atrial Fibrillation
Autoimmune Diseases
Cyclooxygenase Inhibitors
Drug Therapy, Combination
Factor V
Heart
Heart Diseases
Heart Failure
Humans
Hypertension
Immunosuppressive Agents
Male
Middle Aged
Mitral Valve Insufficiency
Multiple Sclerosis
Mutation
Myocardium
Propylene Glycols
Pyrazoles
Sjogren's Syndrome
Sphingosine
Sulfonamides

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

22528818