The first report of prosthetic mitral valve thrombosis in a patient with systemic mastocytosis (SM) in Iran has been published recently in the Caspian Journal of Internal Medicine.
The case involved a 52-year-old man with a 40-year history of generalized pigmented skin lesions who had undergone mechanical mitral valve replacement surgery. The patient reported experiencing dyspnea (shortness of breath) upon exertion.
This individual, who had a history of cutaneous mastocytosis, had undergone mitral valve replacement surgery three times over a ten-year period.
Although the patient was receiving appropriate anticoagulation therapy, he reported experiencing recurrent episodes of prosthetic valve thrombosis.
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Treatment following diagnosis
Following a number of medical consultations, it was determined that the patient’s recurrent prosthetic mitral valve thrombosis was associated with the effect of excessive histamine release, which was caused by the presence of mastocytosis.
Based on his diagnosis, he was prescribed systemic corticosteroids. A bone marrow biopsy was recommended, but the patient declined the procedure. Outpatient hematology consultations were scheduled for additional assessment of systemic and hematologic symptoms, but this patient did not show up for any of his appointments.
Because of the interesting cardiac manifestations reported in this individual, the data were published as soon as possible, in order to serve “as an alerting beacon on such an uncommon cardiac feature of mastocytosis.” Long-term follow-up on the results of treatment are thus not yet available.
Of note, even though cardiac complications may be the initial presentation of SM, the disorder actually may be diagnosed long after the first symptoms have been reported.
“Regarding our case report, we recommend [that] our colleagues . . . closely monitor and remain vigilant for possible cardiac symptoms [in] mastocytosis patients with prosthetic cardiac valves,” the authors concluded.
