Non-Bacterial Thrombotic Endocarditis in a Patient with Rheumatoid Arthritis.
Rheumatoid arthritis (RA) is frequently associated with various extra-joint complications. Although rare, thromboembolic complications are associated with high morbidity and mortality. We experienced a very rare case of nonbacterial thrombotic endocarditis (NBTE) and subsequent embolic stroke in a patient with RA. A 72-year-old male with a 15-year history of RA suddenly developed neurologic symptoms of vomiting and dizziness. Brain magnetic resonance imaging revealed recently developed multiple cerebellar and cerebral lacunar infarctions. Echocardiography showed a pulsating mitral valve vegetation involving the posterior cusp of the mitral valve leaflet, which was confirmed as NBTE. Immediate anti-coagulation therapy was started. The NBTE lesion disappeared in follow-up echocardiography after 4 weeks of anti-coagulation treatment.
Department of Rheumatology, Yonsei University Wonju College of Medicine, Wonju, Korea.
Jung-Hye
JH
Choi
Department of Rheumatology, Yonsei University Wonju College of Medicine, Wonju, Korea.
Jeong-Eun
JE
Park
Department of Cardiology, Yonsei University Wonju College of Medicine, Wonju, Korea.
Jang-Young
JY
Kim
Department of Rheumatology, Yonsei University Wonju College of Medicine, Wonju, Korea.
Taeyoung
T
Kang
Arthritis, rheumatoid; Endocarditis, non-infective; Mitral valve