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Báo cáo y học: "Culture-negative bivalvular endocarditis with myocardial destruction in a patient with systemic lupus erythematosus: a case report."

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Wertheim cung cấp cho các bạn kiến thức về ngành y đề tài: Culture-negative bivalvular endocarditis with myocardial destruction in a patient with systemic lupus erythematosus: a case report. | Laurence and Suh Journal of Cardiothoracic Surgery 2011 6 109 http www.cardiothoracicsurgery.Org content 6 1 109 JCTS JOURNAL OF CARDIOTHORACIC SURGERY CASE REPORT Open Access Culture-negative bivalvular endocarditis with myocardial destruction in a patient with systemic lupus erythematosus a case report Brett R Laurence and Byungse Suh Abstract Culture-negative endocarditis has long been associated with systemic lupus erythematosus but is usually asymptomatic or involves a single valve. We present a patient with destructive culture-negative endocarditis that remains without a microbial etiology despite an exhaustive workup using advanced diagnostic techniques in a patient with systemic lupus erythematosus. Background Culture-negative endocarditis CNE is known by many names including marantic endocarditis ME non-bac-terial thrombotic endocarditis verrucous endocarditis and Libman-Sacks vegetations in collagen vascular diseases specifically systemic lupus erythematosus SLE . First described by Zeigler 1 in 1888 and derived from the Greek marantikos meaning wasting away ME typically involves a single valve with rare involvement of two or more valves 2 . Structural valve disease is common in the SLE population and the valve abnormality usually consists of leaflet thickening with small vegetations often discovered at autopsy 2 3 . The pathophysiology of vegetation formation is not entirely understood but involves platelet deposition on a damaged endothelial surface possibly from up-regulated cytokines and immune complex damage with an absence of inflammatory cells 3 4 . Though typically asymptomatic there is an excess incidence of stroke embolism and heart failure. Valvular lesions appear to be unrelated to duration or activity of illness and may occur at any time 2 . There are few cases of multi-valvular involvement with ME and even fewer cases that involve direct myocardial damage. We present the case of a woman with SLE admitted for an elective mitral valve repair .