Severe mitral stenosis as the first manifestation of systemic lupus erythematosus in a 20-year-old woman: the value of magnetic resonance imaging in the diagnosis of Libman-Sacks endocarditis.
We report a case of severe mitral stenosis caused by Libman-Sacks endocarditis, as an initial manifestation of systemic lupus erythematosus (SLE) in a 20-year-old woman. Cardiac magnetic resonance imaging (MRI) demonstrated a thickening of the mitral valve with basal endocardial thickening exhibiting defect on first-pass perfusion short-axis acquisition and delayed enhancement in keeping with extensive fibrous endocarditis. The patient underwent successful mechanical mitral valve replacement. This case illustrates that MRI is useful in diagnosing this recognised but uncommon cardiac complication of SLE and excluding differential diagnosis such as valve tumour and infective endocarditis with perivalvular abscesses.
Service de Radiologie A, Hopital Cochin, 27 Rue du Faubourg St Jacques, 75014, Paris, France, princetgouya@yahoo.fr.
Hervé
H
Gouya
Laure
L
Cabanes
Luc
L
Mouthon
Alain
A
Pavie
Paul
P
Legmann
Olivier
O
Vignaux
D003937:Diagnosis, Differential; D004696:Endocarditis / Q000175:diagnosis* / Q000209:etiology* / Q000601:surgery; D005260:Female; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000150:complications* / Q000175:diagnosis*; D019028:Magnetic Resonance Imaging, Cine / Q000379:methods*; D008946:Mitral Valve Stenosis / Q000175:diagnosis* / Q000209:etiology* / Q000601:surgery; D055815:Young Adult