title: ANA-Negative Lupus Presenting with Heart Failure and Severe Valvular Dysfunction: Case Report and Review of the Literature.
abstract: Antinuclear antibody (ANA) negative lupus is an important subset of the systemic lupus erythematosus (SLE) disease spectrum. Since the introduction of human cell line for ANA assay, the occurrence of true ANA-negative SLE has been a rare clinical phenomenon. The nature of cardiac involvement in ANA-negative SLE is not well understood, although any cardiac involvement, including valvular dysfunction, should be considered as a presenting manifestation of SLE irrespective of serology status. Early recognition and intervention appears to be associated with decreased morbidity. The following report describes our first case of ANA-negative SLE with an initial presentation of severe cardiac valvular dysfunction and heart failure. It also characterizes the spectrum of disease severity in ANA-negative SLE and demonstrates how aggressive SLE therapy can improve cardiac disease.
authors.affiliation: Baylor College of Medicine, Houston, Texas.
authors.forename: Vu
authors.initials: V
authors.lastname: Hoang
authors.affiliation: Baylor College of Medicine, Houston, Texas.
authors.forename: Daniel
authors.initials: D
authors.lastname: Addison
authors.affiliation: Baylor College of Medicine, Houston, Texas.
authors.forename: Nasser
authors.initials: N
authors.lastname: Lakkis
authors.affiliation: Baylor College of Medicine, Houston, Texas.
authors.forename: Rashed
authors.initials: R
authors.lastname: Tabbaa
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000328:Adult; D000974:Antibodies, Antinuclear / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D001706:Biopsy; D018618:Echocardiography, Doppler, Color; D017548:Echocardiography, Transesophageal; D005260:Female; D005455:Fluorescent Antibody Technique; D006333:Heart Failure / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D006349:Heart Valve Diseases / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008180:Lupus Erythematosus, Systemic / Q000097:blood / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy / Q000276:immunology; D011237:Predictive Value of Tests; D012698:Serologic Tests; D012720:Severity of Illness Index; D013256:Steroids / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D000319:Adrenergic beta-Antagonists; D000974:Antibodies, Antinuclear; D015415:Biomarkers; D007166:Immunosuppressive Agents; D013256:Steroids
keywords: ANA-negative lupus; heart failure; valvular dysfunction