Key result
Mechanical MVR successfully manages nonbacterial thrombotic endocarditis in a patient with antiphospholipid syndrome.
Why the study?
Libman-Sacks endocarditis can present with clinical features mimicking infection, complicating diagnosis and management in antiphospholipid syndrome patients.
Case Report (n=1)
A 56-year-old woman was admitted due to new ulceration and acute digital ischaemia on a background of chronic leg ulcers bilaterally. Vasculitis screening returned strongly positive lupus anticoagulant levels and elevated anticardiolipin antibodies; these remained elevated at repeat testing. A diagnosis of antiphospholipid syndrome was made. Transthoracic echocardiogram identified a mitral valve lesion suggestive of vegetation and mild mitral valve regurgitation. Blood cultures taken throughout her inpatient admission were negative. Mechanical mitral valve replacement was performed 3 months later, and subsequent culture of the excised tissue returned as sterile. Histological examination showed no morphological signs of infective endocarditis.
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Sexton et al. (2022) conducted a case report in Libman-Sacks endocarditis and antiphospholipid syndrome (n=1). Mechanical mitral valve replacement was evaluated. Mechanical mitral valve replacement was performed in a 56-year-old woman with antiphospholipid syndrome, with histology confirming sterile tissue and no morphological signs of infective endocarditis.
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