Aseptic Vegetation in Pulmonary Artery Valve, Finding in a Patient with Systemic Lupus Erythematosus. Case report

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Jessica Ariatna Carreto Navarrete
Estanislao Antonio Calixto
David Sandoval Sánchez
Johan Mendoza Alva
Alejandro Daniel Huerta Carranza
Yunelly Paola Sarmiento Sosa
Karla Ruth Galindo Meza
Charit Nayelly Chang Cruz
Marcos García Aranda
Hazael López Arana
David Balcázar Quezada

Abstract




Systemic lupus erythematosus (SLE) is an entity that promotes the formation of autoantibodies that trigger immune complexes that damage various organs of the body. Worldwide, SLE has a prevalence of 13-7000 per 100,000 people and leads to a high mortality from cardiovascular diseases, as well as the risk of developing lupus nephritis (LN) in 60% of cases. We present the case of a 41-year-old patient with a history of recently diagnosed arterial hypertension and bronchial hyperreactivity of 20 years of evolution, admitted for 1 month of evolution with asthenia, myalgia, arthralgia and fever; she identifies malar erythematous dermatosis and systolic murmur in a pulmonary focus. When presenting with proteinuria, microhematuria and renal functional impairment, positive ANAs were performed, which is why it was classified as lupus nephropathy, and she needed to start hemodialysis. In the presence of the murmur, an echocardiogram was performed, which showed a pulmonary valve with a 1cm image of vegetation, causing moderate regurgitation. With the diagnosis of Libman-Sacks endocarditis, anticoagulant treatment, steroids, and mycophenolate were started, evolving to normal renal function.




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How to Cite
Carreto Navarrete , J. A. ., Antonio Calixto, E., Sandoval Sánchez, D. ., Mendoza Alva, J. ., Huerta Carranza, A. D. ., Sarmiento Sosa, Y. P. ., Galindo Meza, K. R. ., Chang Cruz, C. N. ., García Aranda, M. ., López Arana, H. ., & Balcázar Quezada, D. . (2023). Aseptic Vegetation in Pulmonary Artery Valve, Finding in a Patient with Systemic Lupus Erythematosus. Case report . International Journal of Medical Science and Clinical Research Studies, 3(02), 244–246. https://doi.org/10.47191/ijmscrs/v3-i2-17
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References

I. Watana kunakorn C, Burket T. Infective endocarditis at a large community teaching hospital, 1980-1990. A review of 210 episodes. Medicine (Baltimore) 1993; 72: 90-102.

II. Anders HJ, Saxena R, Zhao M-H, Parodis I, Salmon JE, Mohan C. Lupus nephritis. Nat Rev Dis Primers. 2020;6(1):7.

III. Yafasova A, Fosbøl EL, Schou M, Baslund B, Faurschou M, Docherty KF, et al. Long-term cardiovascular outcomes in systemic lupus erythematosus. J Am Coll Cardiol. 2021;77(14):1717–27.

IV. Todolí-Parra JA, Tung-Chen Y, Micó L, Gutiérrez J, Hernández-Jaras J, Ruiz-Cerda JL. Lupus nephritis with preserved kidney function associated with poorer cardiovascular risk control: A call for more awareness. Hipertens Riesgo Vasc. 2018;35(3):110–8.

V. Huang S, Huang F, Mei C, Tian F, Fan Y, Bao J. Systemic lupus erythematosus and the risk of cardiovascular diseases: A two-sample Mendelian randomization study. Front Cardiovasc Med. 2022;9: 896499.

VI. Giannelou M, Mavragani CP. Cardiovascular disease in systemic lupus erythematosus: A comprehensive update. J Autoimmun. 2017; 82: 1–12.

VII. Watanakunakorn C, Burket T. Infective endocarditis at a large community teaching hospital, 1980-1990. A review of 210 episodes. Medicine (Baltimore) 1993; 72: 90-102.

VIII. Hecht SR, Berger M. Right-sided endocarditis in intravenous drugs users. Pronostic features in 102 episodes. Ann Intern Med 1992;117: 560-566

IX. Ibrahim AM, Siddique MS. Libman Sacks Endocarditis. StatPearls Publishing; 2022.

X. Fanouriakis A, Tziolos N, Bertsias G, Boumpas DT. Update οn the diagnosis and management of systemic lupus erythematosus. Ann Rheum Dis 2021;80(1):14–25.

XI. Fanouriakis A, Kostopoulou M, Cheema K, et al. 2019 update of the joint European League against rheumatism and European renal Association-European dialysis and transplant association (EULAR/ERA-EDTA) recommendations for the management of lupus nephritis. Ann Rheum Dis 2020; 79:713–23.

XII. Czub P, Żbikowska K, Arendarczyk A, Budnik M. Aortic valve Libman-Sacks endocarditis mimicking papillary fibroelastoma: therapeutic possibilities. Pol Arch Intern Med. 2022; 132(7–8).

XIII. Choi JH, Park JE, Kim JY, Kang T. Non-bacterial thrombotic endocarditis in a patient with rheumatoid arthritis. Korean Circ J. 2016;46(3):425–8.

XIV. Baddour LM, Wilson WR, Bayer AS, Fowler VG Jr, Tleyjeh IM, Rybak MJ, et al. Infective endocarditis in adults: Diagnosis, antimicrobial therapy, and management of complications: A scientific statement for healthcare professionals from the American Heart Association: A scientific statement for healthcare professionals from the American Heart Association. Circulation [Internet]. 2015;132(15): 1435–86.

XV. Chalvon NB, Pennaforte JL, Servettaz A, Boulagnon C, Gavand PE, Lekieffre M, et al. Les valvulopathies sévères associées au LES et/ou au SAPL (dont l’endocardite de Libman-Sachs) sont une complication du syndrome des anti-phospholipides : analyse rétrospective de 23 patients opérés. Rev Med Interne [Internet]. 2021;42: A84–5.

XVI. Sanfilippo AJ, Picard MH, Newell JB, Rosas E, Davidoff R, Thomas JD, et al. Echocardiographic assesment of patients with infectious endocarditis. Prediction of risk for complications. J Am Coll Cardiol 1991; 18: 1191-1199

XVII. Goldman ME, Fisher EA, Winters S, Reichstein R, Stavile K, Gorlin R, et al. Early identification of patients with native valve infectious endocarditis at risk for major complications by initial clinical presentation and baseline echocardiography. Int J Cardiol 1995; 52: 257-264.

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