Key result
Immunosuppression and HF management resolve severe MR in a pediatric case of Libman-Sacks endocarditis.
Why the study?
Libman-Sacks endocarditis is an uncommon manifestation of systemic lupus erythematosus that can be confused with infective endocarditis and cause heart failure.
Does immunosuppressive therapy improve heart failure symptoms in a pediatric patient with Libman-Sacks endocarditis secondary to systemic lupus erythematosus?
Case Report (n=1)
No
Does immunosuppressive therapy improve heart failure symptoms in a pediatric patient with Libman-Sacks endocarditis secondary to systemic lupus erythematosus?
Libman-Sacks endocarditis is a significant cardiac manifestation of systemic lupus erythematosus that can present as heart failure and responds well to immunosuppressive therapy.
Answers are grounded in this paper and cite their sources.
May support immunosuppression for heart failure in pediatric Libman-Sacks endocarditis; leaves open need for prospective trials.
Libman-Sacks endocarditis (LSE) is an uncommon disorder that might be confused with infective endocarditis. It is one of the systemic lupus erythematosus (SLE) manifestations that could present with heart failure. We report a 12-year-old girl who presented with a history of shortness of breath, joint pain for four weeks, and fever for about one week. On examination, she was pale, edematous, and febrile. Her cardiac exam revealed a pan-systolic murmur of mitral regurgitation, harsh, grade 3/6 best heard at the apex. She was diagnosed with systemic lupus erythematosus with lupus nephritis and carditis. Her echocardiography revealed severe mitral regurgitation with nodular thickening of the valve in keeping with a diagnosis of LSE. After appropriate management of her underlying disorder using immunosuppressive, we saw a dramatic clinical improvement and her heart failure symptoms resolved. This case proves that SLE can have significant cardiac involvement and a proper evaluation would help in overall management and prognosis.
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Riyami et al. (2022) conducted a case report in Libman-Sacks endocarditis and systemic lupus erythematosus (n=1). Immunosuppressive therapy and heart failure medications was evaluated on Clinical and echocardiographic improvement. Immunosuppressive therapy and heart failure management led to dramatic clinical improvement and resolution of severe mitral regurgitation in a 12-year-old girl with Libman-Sacks endocarditis.
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