Unmasking the Hidden Peril: A Case Report of Ankylosing Spondylitis Revealing a Giant Aortic Aneurysm

Background: Ankylosing Spondylitis is a chronic inflammatory rheumatic disease with both articular and extra-articular features. While cardiovascular involvement in Ankylosing spondylitis is rare, it can be life-threatening. This condition is typically associated with the HLAB27 antigen and often presents in the advanced stages of the disease. This case is particularly uncommon as cardiovascular involvement was identified at the time of diagnosis in a patient who tested negative for HLA-B27.

Case presentation: Here, we present an uncommon case of a 37-year-old male with 3 years of evolving Ankylosing Spondylitis negative for HLA-B27, who was incidentally found to have a giant aortic aneurysm during cardiovascular screening at the time of his rheumatic disease diagnosis. The patient underwent surgical intervention using the Tyron-David procedure. Subsequent post-operative follow-ups revealed satisfactory outcomes without complications, Conclusion: Even in the absence of clinical signs, and even in the early stages of Ankylosing spondylitis, it is necessary to screen for this condition, at least with transthoracic ultrasound. Early screening ensures prompt treatment, which will save the patient's life.