Converging pathways of ankylosing spondylitis and rheumatic fever: A unique case

Ankylosing spondylitis is a chronic inflammatory disease that belongs to the group of seronegative spondyloarthropathies. Rheumatic fever is an abnormal immune response to group A Streptococcus infections. Severe or recurrent episodes of rheumatic fever can lead to significant morbidity and mortality, often resulting in the development of rheumatic heart disease. We present a unique case of a 50-year-old patient who suffered from rheumatic fever during childhood, which was complicated by mitral stenosis. He underwent surgical mitral valve replacement at the age of 35. At 47, he was diagnosed with ankylosing spondylitis following a 3-year history of worsening symptoms. This is the first case in the medical literature describing a patient with mitral stenosis postrheumatic fever coexisting with ankylosing spondylitis. A microbial infection triggering the autoimmune system in genetically susceptible individuals may be the underlying mechanism. However, further research is needed to fully understand the converging pathways of these 2 diseases.