Cardiac Valve Diseases and Antiphospholipid Syndrome

Atsumi, Tatsuya; Koike, Takao

doi:10.2169/internalmedicine.39.446

Cited by 2 publications

(3 citation statements)

References 17 publications

(17 reference statements)

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“…Atsumi and Koike [19] reported that more than 90% of arterial events were cerebrovascular in APS patients [20]. Ischemic heart disease is rare, but valvular disease is frequent, which correlates with cerebrovascular thromboembolic complications in APS patients.…”

Section: Discussionmentioning

confidence: 99%

“…This also means that infarcts in the vertebrobasilar system were more common in patients with aPL than in patients without aPL. Five patients in the aPL-positive group showed basilar syndrome that is probably attributable to a cardioembolic mechanism [19, 21]. There are several reports concerning angiographic findings in patients with APS [35, 36].…”

Section: Discussionmentioning

confidence: 99%

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Clinical Characteristics of Stroke Patients with Antiphospholipid Antibodies

Terashi

Uchiyama²,

Hashimoto³

et al. 2005

Cerebrovasc Dis

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Background: Antiphospholipid syndrome is important as a cause of ischemic stroke, although clinical characteristics of the syndrome are not well documented. Methods: We analyzed differences in clinical characteristics between 40 antiphospholipid-antibody (aPL)-positive and 40 aPL-negative stroke patients. Results: Stroke patients with aPL were significantly younger and were more likely to be women in comparison with stroke patients without aPL. Valvular heart disease, neurological complications and hematological disorders were more frequent in the aPL-positive group. The mean value of thrombin-antithrombin III complex was significantly lower in the aPL-positive group. Cerebral infarctions in the carotid system were less and large-artery lesions more frequent in the aPL-positive patients. Conclusions: Stroke patients with aPL have clinical characteristics distinct from stroke patients without aPL.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Clinical Characteristics of Stroke Patients with Antiphospholipid Antibodies

Terashi

Uchiyama²,

Hashimoto³

et al. 2005

Cerebrovasc Dis

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“…On day 43, we also initiated 35 mg/day of prednisolone since TEE on day 42 revealed no reduction in vegetation size. A previous study has shown that the inflammatory reaction in the affected valves can be suppressed by steroids due to the immune-mediated mechanisms in due to the immune-mediated mechanisms in APS [ 5 , 6 ]. Other research has found a combination of low-dose prednisolone, aspirin, and heparin can be of benefit in women with APS refractory to the standard treatment [ 7 ].…”

Section: Case Reportmentioning

confidence: 99%

Mitral Valve Replacement for Enlarged Libman-Sacks Endocarditis in a Patient with Persistent Primary Antiphospholipid Syndrome and Recurrent Stroke: A Case Report

et al. 2023

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Patient: Male, 41-year-old Final Diagnosis: Cerebral infarction • Libman-Sacks endocarditis • primary antiphospholipid syndrome Symptoms: Dizziness Clinical Procedure: — Specialty: Neurology Objective: Rare coexistence of disease or pathology Background: Anticardiolipin antibodies in patients with Libman-Sacks endocarditis (LS) are indicative of comorbid antiphospholipid syndrome (APS) and can result in cerebral infarctions. We describe a case of LS and primary APS with recurrent cerebral infarctions despite anticoagulation treatment. The patient underwent surgery for enlarged LS vegetation with high titers of antiphospholipid antibodies. Case Report: A 41-year-old Japanese man was admitted to hospital for small cerebral infarction recurrence in a left parietal lesion. At age 35, the patient had suffered multiple cerebral infarctions. He was found to have high serum titers of all 3 antiphospholipid antibodies. Transesophageal echocardiography (TEE) findings were normal. Differential diagnosis ruled out other autoimmune diseases and a clinical diagnosis of primary APS was made. Warfarin anticoagulation was started. When cerebral infarction recurred 6 years after the first episode, serum titers of antiphospholipid antibodies remained high, and TEE showed a 7×8 mm area of mitral vegetation. A TEE results from his first admission revealed a 5×6 mm area of mitral vegetation, which was believed to be related to the current vegetation. As anticoagulation produced no improvement, the mitral valve was replaced with a mechanical valve. Examination of the excised vegetation found it to be consistent with LS. The patient made good progress within 3 years after surgery. Conclusions: LS size can increase despite anticoagulation in cases with high titers of all 3 antiphospholipid antibodies and cerebral infarction. Such patients require ongoing TEE follow-up and surgical treatment should be considered.

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Cardiac Valve Diseases and Antiphospholipid Syndrome

Cited by 2 publications

References 17 publications

Clinical Characteristics of Stroke Patients with Antiphospholipid Antibodies

Clinical Characteristics of Stroke Patients with Antiphospholipid Antibodies

Mitral Valve Replacement for Enlarged Libman-Sacks Endocarditis in a Patient with Persistent Primary Antiphospholipid Syndrome and Recurrent Stroke: A Case Report

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