Libman-Sacks Endocarditis of Right Native Valves in the Context of Antiphospholipid Syndrome and Systemic Lupus Erythematosus: When Treatment Makes a Difference!
DOI:
https://doi.org/10.37615/retic.v3n1a5Keywords:
endocarditis, Libman-Sacks, antiphospoplipid, lupus.Abstract
We report the case of a 54-year-old woman with antiphospholipid syndrome in irregular therapy, admitted due to exertional dyspnea and orthopnea. The transthoracic echocardiogram showed dilated cardiomyopathy with biventricular systolic dysfunction, pulmonary hypertension and masses related to the pulmonary and tricuspid valves without autonomic movement. The crops and white count were normal, with alteration of the SAF test. In addition, SLE was diagnosed. It was started therapy for heart failure, steroids, rituximab and anticoagulation, with improving of the symptoms. The control echocardiogram showed remission of the tricuspid masses and similar dimensions of the pulmonary mass.
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Moyssakis I, Tektonidou MG, Vassilliou VA, et al. Libman-Sacks endocarditis in systemic lupus erythematosus: Prevalence, associations, and evolution. Am J Med 2007; 120: 636-642. doi: https://doi.org/10.1016/j.amjmed.2007.01.024
Sharma J, Lasic Z, Bornstein A, et al. Libman-Sacks endocarditis as the first manifestation of systemic lupus erythematosus in an adolescent, with a review of the literature. Cardiol Young 2013; 23: 1-6. doi: https://doi.org/10.1017/S1047951112001023
Bordin G, Boldorini R, Meroni PL. The two hit hypothesis in the antiphospholipid syndrome: Acute ischaemic heart involvement after valvular replacement despite anticoagulation in a patient with secondary APS. Lupus 2003; 12: 851-853. doi: https://doi.org/10.1191/0961203303lu445cr
Vinales KL, Gopalan RS, Lanza LA, et al. Unusual case of nonbacterial thrombotic endocarditis attributable to primary antiphospholipid syndrome. Circulation 2010; 122: e459-460. doi: https://doi.org/10.1161/CIRCULATIONAHA.110.954032
Vianna JL, Khamashta MA, Ordi-Ros J, et al. Comparison of the primary and secondary antiphospholipid syndrome: a European multicenter study of 114 patients. Am J Med 1994; 96 (1): 3-9. doi: https://doi.org/10.1016/0002-9343(94)90108-2
Laufer J, Frand M, Milo S. Valve replacement for severe tricuspid regurgitation caused by Libman-Sacks endocarditis. Br Heart J 1982; 48 (3): 294-297. doi: https://doi.org/10.1136/hrt.48.3.294
Bhimani AA, Hoit BD. Extensive nonbacterial thrombotic endocarditis isolated to the tricuspid valve in primary antiphospholipid syndrome. J Am Echocardiogr 2010; 23 (1): 107.e5-6. doi: https://doi.org/10.1016/j.echo.2009.07.019
Ziporen L, Goldberg I, Arad M, et al. Libman-Sacks endocarditis in the antiphospholipid syndrome: immunopathologic findings in deformed heart valves. Lupus 1996; 5 (3):196-205. doi: https://doi.org/10.1177/096120339600500306
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Copyright (c) 2020 Alma Stella Arrioja Salazar, Luis Emiro Velazco
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