# Cardiovascular Manifestations of Pseudoxanthoma Elasticum

**Authors:** Aimee Willett, Vivek V Jasti, Sean M Muir, Jay Anderson

PMC · DOI: 10.7759/cureus.87113 · Cureus · 2025-07-01

## TL;DR

This paper discusses a case of pseudoxanthoma elasticum and its cardiovascular complications, emphasizing the need for comprehensive evaluation and multidisciplinary care.

## Contribution

The paper presents a novel case linking PXE with potential cardiovascular and gastrointestinal manifestations.

## Key findings

- PXE can manifest with cardiovascular complications like arterial calcification.
- A multidisciplinary approach is essential for managing PXE-related conditions.
- Early symptoms like leg cramping and satiety may signal underlying cardiovascular issues.

## Abstract

Pseudoxanthoma elasticum (PXE) is a rare systemic disorder of elastic fibers. The most common manifestations include characteristic papules and ocular angioid streaks. Cardiovascular complications include peripheral arterial disease, hypertension, premature coronary artery disease, and cerebrovascular disease. These associations are secondary to dystrophic elastic fibers, resulting in the calcification of small- to medium-sized arteries.

We present the case of a 22-year-old otherwise healthy female patient diagnosed with PXE following a biopsy of a neck lesion. Ophthalmologic evaluation revealed characteristic angioid streaks. The patient also reported early satiety and leg cramping, which prompted referral to gastroenterology and cardiology. Further investigation raised concern for median arcuate ligament syndrome (MALS), though the association with her PXE diagnosis remains unclear.

This case highlights the importance of systematic evaluation, screening, and multidisciplinary management of cardiovascular manifestations in PXE.

## Linked entities

- **Diseases:** Pseudoxanthoma Elasticum (MONDO:0009925), peripheral arterial disease (MONDO:0005386), cerebrovascular disease (MONDO:0011057), median arcuate ligament syndrome (MONDO:0017388)

## Full-text entities

- **Genes:** CFTR (CF transmembrane conductance regulator) [NCBI Gene 1080] {aka ABC35, ABCC7, CF, CFTR/MRP, MRP7, TNR-CFTR}, TRPV1 (transient receptor potential cation channel subfamily V member 1) [NCBI Gene 7442] {aka VR1}, CSF1R (colony stimulating factor 1 receptor) [NCBI Gene 1436] {aka BANDDOS, C-FMS, CD115, CSF-1R, CSFR, FIM2}, ELN (elastin) [NCBI Gene 2006] {aka ADCL1, SVAS, WBS, WS}, NLRP1 (NLR family pyrin domain containing 1) [NCBI Gene 22861] {aka AIADK, CARD7, CIDED, CLR17.1, DEFCAP, DEFCAP-L/S}, ABCC6 (ATP binding cassette subfamily C member 6) [NCBI Gene 368] {aka ABC34, ARA, EST349056, GACI2, MLP1, MOAT-E}, ABCC1 (ATP binding cassette subfamily C member 1 (ABCC1 blood group)) [NCBI Gene 4363] {aka ABC29, ABCC, DFNA77, GS-X, MRP, MRP1}, SELE (selectin E) [NCBI Gene 6401] {aka CD62E, ELAM, ELAM1, ESEL, LECAM2, selectin-e}
- **Diseases:** chronic mesenteric ischemia (MESH:D065666), coronary artery disease (MESH:D003324), abdominal bloating (MESH:D000007), myocardial infarction (MESH:D009203), aneurysm (MESH:D000783), ventilatory limitation (MESH:D012131), aortic regurgitation (MESH:D001022), diastolic dysfunction (MESH:D018487), PXE (MESH:D011561), cerebral microvascular disease (MESH:D017566), arterial calcification (MESH:D061205), gastrointestinal involvement (MESH:D005767), peripheral arterial disease (MESH:D058729), papules (MESH:D000169), choroidal neovascularization (MESH:D020256), vascular anomaly (MESH:D020785), hyperlipidemia (MESH:D006949), Cardiovascular complications (MESH:D002318), cerebrovascular disease (MESH:D002561), hypertension (MESH:D006973), calcification (MESH:D002114), atrial fibrillation (MESH:D001281), Angioid streaks (MESH:D000793), skin and mucous membrane lesion (MESH:D010390), fatigue (MESH:D005221), thromboembolic (MESH:D013923), palpitations (MESH:D006331), oral mucosal lesions (MESH:D009059), hereditary disorder (MESH:D009386), dilation of the aorta (MESH:D002311), neck lesion (MESH:D006258), central vision distortion (MESH:D014786), peripheral vascular disease (MESH:D016491), stroke (MESH:D020521), hemorrhage (MESH:D006470), atherosclerotic plaques (MESH:D058226), systemic disorder (MESH:D009422), sudden cardiac death (MESH:D016757), skin lesion (MESH:D012871), atherosclerosis (MESH:D050197), fibroelastosis (MESH:D004695), restrictive cardiomyopathy (MESH:D002313), MALS (MESH:D000074742), arrhythmias (MESH:D001145), angina (MESH:D000787), cramping (MESH:D009120), cardiocirculatory impairment (MESH:D060825), coronary, valvular, or large vessel disease (MESH:D003330), heart failure (MESH:D006333), Monckeberg's arteriosclerosis (MESH:D001161), vascular hyperplasia (MESH:D006965), aortic stenosis (MESH:D001024), metabolic defect (MESH:D008659), dyspnea (MESH:D004417)
- **Chemicals:** lipid (MESH:D008055), warfarin (MESH:D014859), cholesterol (MESH:D002784), oxygen (MESH:D010100), agents (-)
- **Species:** Homo sapiens (human, species) [taxon 9606]

## Full text

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## Figures

2 figures with captions in the complete paper: https://tomesphere.com/paper/PMC12312814/full.md

## References

18 references — full list in the complete paper: https://tomesphere.com/paper/PMC12312814/full.md

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Source: https://tomesphere.com/paper/PMC12312814