Increased vascular occlusion in patients with pseudoxanthoma elasticum

Background: Pseudoxanthoma elasticum (PXE) is an autosomal recessive inherited multisystem disorder of the connective tissue caused by a loss-of-function mutation of the ABCC6 gene. It can affect the cardiovascular system, presumably leading to a high prevalence of atherosclerosis. Patients and methods: 46 PXE patients and 18 controls underwent an angiological examination consisting of measurement of ankle-brachial index (ABI), strain-gauge arterial reserve (SGAR), arterial resting perfusion, pulse wave index (PWI), central pulse wave velocity, and ultrasound examination. Results: With an average age of 51.4 +/- 12.4 years, 35/46 (76.1 %) of the PXE patients had atherosclerotic lesions, and 10 of them (28.6%) had a chronic vascular occlusion of one or more peripheral vessels. 34/46 (73,9%) had a pathologic ABI <0.9, 15/42 (35.7 %) had a pathological SOAR <10 mL/100 mL tissue/min, and 23/38 (60.5%) had a pathological PWI >180. The differences between the groups were statistically significant for ABI, arterial reserve, and PWI. Conclusions: In PXE patients atherosclerosis was found with a much higher prevalence than expected. Moreover, they were at very high risk for total vessel occlusions.