Ischemic Stroke Revealing Libman-Sacks Endocarditis as the Initial Manifestation of Lupus Erythematosus With Secondary Antiphospholipid Syndrome: A Case Report.

Autor: El Koubayati G; Internal Medicine and Clinical Immunology, Lebanese University Faculty of Medicine, Beirut, LBN., Sandakly N; Internal Medicine, Lebanese University Faculty of Medicine, Beirut, LBN., Jabbour I; Internal Medicine, Lebanese University Faculty of Medicine, Beirut, LBN., Haddad F; Internal Medicine and Clinical Immunology, Lebanese Hospital Geitaoui - University Medical Center, Beirut, LBN., Khalil M; Cardiology, Lebanese Hospital Geitaoui - University Medical Center, Beirut, LBN.
Jazyk: angličtina
Zdroj: Cureus [Cureus] 2024 Oct 05; Vol. 16 (10), pp. e70870. Date of Electronic Publication: 2024 Oct 05 (Print Publication: 2024).
DOI: 10.7759/cureus.70870
Abstrakt: Libman-Sacks endocarditis (LSE), also known as nonbacterial thrombotic endocarditis (NBTE), is a rare condition characterized by noninfectious lesions on the heart valves with the deposition of thrombi. NBTE is most commonly linked to advanced malignancy, systemic lupus erythematosus, and antiphospholipid syndrome (APS). In many cases, NBTE is only diagnosed postmortem during autopsies, with embolization being the most frequent clinical manifestation. A high level of clinical suspicion is essential for diagnosis. Despite treatment involving anticoagulation and addressing the underlying etiology, the prognosis remains generally poor. We present the case of a 40-year-old woman admitted with new-onset dysarthria and upper motor weakness. Clinical evaluation, laboratory testing, and imaging revealed a stroke accompanied by valvular vegetations, which were linked to secondary APS. The patient was diagnosed with LSE and treated with anticoagulation. Neurological manifestations, such as embolization, are common in NBTE, often occurring in otherwise asymptomatic patients. Despite management of the acute condition, NBTE continues to be associated with high morbidity and mortality.
Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.
(Copyright © 2024, El Koubayati et al.)
Databáze: MEDLINE