Libman-Sacks endocarditis and oral anticoagulation.
The patient is a 34-year-old female with systemic lupus erythematosus and secondary antiphospholipid antibody syndrome, who evolved with convulsive crises, partially controlled with an anticonvulsant, and auscultation of a cardiac murmur, whose investigation showed the presence of a mitral valve vegetation. Once the diagnosis of Libman-Sacks endocarditis was established, therapy with warfarin sodium was initiated, and, after 6 months of oral anticoagulation, the patient had total control of the convulsive crises and the valvular vegetation disappeared on echocardiography. This study discusses the occurrence of Libman-Sacks endocarditis in systemic lupus erythematosus, its association with antiphospholipid antibody syndrome, and the anticoagulant therapy. A literature review is also provided.
Serviço de Reumatologia, Hospital das Clínicas da Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil. fabdoc@globo.com
Fabiano Almeida
FA
Brito
Magali L M C
ML
Tófani
Fábio Avila
FA
Tófani
Adriana Maria
AM
Kakehasi
Cristina Costa Duarte
CC
Lanna
Marco Antonio Parreiras
MA
Carvalho
D000284:Administration, Oral; D000328:Adult; D000925:Anticoagulants / Q000008:administration & dosage*; D016736:Antiphospholipid Syndrome / Q000150:complications; D017548:Echocardiography, Transesophageal; D004696:Endocarditis / Q000150:complications / Q000188:drug therapy*; D005260:Female; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000150:complications / Q000188:drug therapy*; D008943:Mitral Valve / Q000000981:diagnostic imaging; D014859:Warfarin / Q000008:administration & dosage*
D000925:Anticoagulants; D014859:Warfarin