Nonbacterial Thrombotic Endocarditis Complicated by Cerebral Infarction in a Patient with Adenomyosis with High Serum CA125 Level; A Case Report

Uchino, Kenji; Shimizu, Takahiro; Mizukami, Heisuke; Isahaya, Kenji; Ogura, Hana; Shinohara, Kensuke; Hasegawa, Yasuhiro

doi:10.1016/j.jstrokecerebrovasdis.2017.09.064

Cited by 18 publications

(27 citation statements)

References 9 publications

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“…Regarding the pathophysiologic mechansim of acute cerebral infarction with adenomyosis, we consulted previous cases and found 13 patients in the cases [2][3][4][5][6][7][8]. The median age of the 13 patients was 45.4 years.…”

Section: Discussionmentioning

confidence: 99%

“…One case showed that adenomyosis can cause hypercoagulable state or diffuse intravascular coagulation (DIC), even lead to organ necrosis [9]. Besides, one case reported a patient with adenomyosis presented fever during menstrual phase, another case showed a patient with adenomyosis presented fever, but none of the two cases mentioned the effect of fever in a patient with acute cerebral infarction with adenomyosis [5,6].…”

Section: Discussionmentioning

confidence: 99%

“…The CA125 level decreased in the 20th day after onset in our patient. Since CA125 is expressed in the peritoneum, pleura, pericardial membrane,and endometrium, high level of CA125 can also be seen in pregnancy, menstruation and endometriosis [6]. The elevation of serum CA125 during menstruation is thought to be related with endometrial cell surface antigen shed into the systemic circulation or peritoneal irritation [8].…”

Section: Discussionmentioning

confidence: 99%

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Acute cerebral infarction with adenomyosis in a patient with fever: a case report

2020

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Background: It is reported that acute cerebral infarction with adenomyosis is associated with elevated D-Dimer, elevated CA125, anemia and menstruation. However, previous reports did not notice infection known as fever, which may be a potential risk factor for developing acute cerebral infarction with adenomyosis. Case presentation: We describe a 34-year-old woman who presented headache and fever (38°C) for 4 days and left limb weakness for 1 day during her menstrual phase. Laboratory test data showed: Hemoglobin (HGB) (112 g/L, normal: 120-150 g/L), Carcinoembryonic antigen 125 (CA125) (937.70 U/ml, normal: 0-35 U/ml), D-Dimer (27.4 mg/L, normal: 0-1.5 mg/L). Magnetic resonance imaging (MRI) indicated acute cerebral infarction in right basal ganglia and subcortical region of right frontotemporal lobe. Further, brain computed tomography angiography (CTA) showed that the M1 segment of right middle cerebral artery was strictured and the distal branches of right middle cerebral artery were significantly less than those on the opposite side. No obvious abnormality was found in cranial magnetic resonance venogram (MRV). She had a 5-year history of adenomyosis. No tumors were found by whole body positron emission tomography-computed tomography (PET-CT). We treated this patient by using antiinfective therapy for 1 week and using anticoagulant therapy with low molecular weight heparin for 2 weeks. Subsequently, the anticoagulant therapy was discontinued and replaced by antiplatelet therapy with clopidogrel. We followed up this patient for 4 months, and no recurrence of cerebral infarction was found. Conclusions: Acute cerebral infarction with adenomyosis may be related to elevated D-Dimer, elevated CA125, anemia and menstruation. Our report suggests that infection may be a potential risk factor for developing acute cerebral infarction with adenomyosis.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Acute cerebral infarction with adenomyosis in a patient with fever: a case report

2020

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“…About half of patients with NBTE present with thromboembolic phenomena including stroke [ 8 ]. Stroke as an initial presentation of NBTE has been reported in patients with advanced-stage pancreatic adenocarcinoma and non-small cell lung cancer [ 9 , 10 ].…”

Section: Discussionmentioning

confidence: 99%

Cancer-Related Non-Bacterial Thrombotic Endocarditis Presenting as Acute Ischemic Stroke

Savarapu¹,

Abdelazeem²,

Isa³

et al. 2021

Cureus

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Non-bacterial thrombotic endocarditis (NBTE), also known as marantic endocarditis, is a rare form of noninfectious endocarditis presenting with thromboembolism including ischemic cerebral stroke. It is mostly associated with advanced malignancy and characterized by the presence of sterile vegetation on heart valves. The diagnosis is usually based on vegetations seen on an echocardiogram, with negative blood cultures suggesting a noninfectious etiology. The treatment for this condition includes systemic anticoagulation. In this report, we discuss the case of a 61-year-old Caucasian female who presented to our facility with an ischemic stroke. She was found to have vegetations on the mitral valve with negative blood cultures. Further studies revealed metastatic pancreatic cancer. The patient's condition improved following in-hospital management, and she was discharged home for outpatient follow-up and treatment. Through this report, we highlight the importance of considering a search for malignancy in patients presenting with these clinical features. Early diagnosis and prompt management are critical to reduce the complications of NBTE and improve the patients' quality of life.

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“…Regarding acute cerebral infarction with adenomyosis, we consulted cases and found 13 patients in the cases [2][3][4][5][6][7][8]. The median age of the 13 patients was 45.4 years.…”

Section: Discussionmentioning

confidence: 99%

Acute cerebral infarction with adenomyosis in a young woman: a case report

Zhao

Zhang

Yang

2019

Preprint

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Background Acute cerebral infarction with adenomyosis in a young woman has been rarely reported. Case presentation We describe a 34-year-old young woman who presented headache and fever (38°C) for 4 days and left limb weakness for 1 day during her menstrual phase. Laboratory test data showed: Hemoglobin (HGB) (112g/L, normal: 120-150 g/L), Carcinoembryonic antigen 125 (CA125) (937.70U/ml, normal: 0-35 U/ml), D-Dimer (27.4mg/L, normal: 0-1.5mg/L). Magnetic resonance imaging (MRI) indicated acute cerebral infarction in right basal ganglia and subcortical region of right frontotemporal lobe. Further, brain computed tomography angiography (CTA) showed that the M1 segment of right middle cerebral artery was strictured and the distal branches of right middle cerebral artery were significantly less than those on the opposite side. No obvious abnormality was found in cranial magnetic resonance venogram (MRV). She had a 5-year history of adenomyosis. No tumors were found by whole body positron emission tomography-computed tomography (PET-CT). We treated this patient by using anti-infective therapy for 1 week and using anticoagulant therapy with low molecular weight heparin for 2 weeks. Subsequently, the anticoagulant therapy was discontinued and replaced by antiplatelet therapy with poliovir. We followed up this patient for 4 months, and no recurrence of cerebral infarction was found. Conclusions Acute cerebral infarction with adenomyosis may be related to elevated D-Dimer, elevated CA125, anemia, menstruation and fever. Our report suggests that acute cerebral infarction with adenomyosis can occur not only in middle-aged women but also in young women, and fever during menstrual phase in a woman with adenomyosis may be a factor leading to acute cerebral infarction.

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Nonbacterial Thrombotic Endocarditis Complicated by Cerebral Infarction in a Patient with Adenomyosis with High Serum CA125 Level; A Case Report

Cited by 18 publications

References 9 publications

Acute cerebral infarction with adenomyosis in a patient with fever: a case report

Acute cerebral infarction with adenomyosis in a patient with fever: a case report

Cancer-Related Non-Bacterial Thrombotic Endocarditis Presenting as Acute Ischemic Stroke

Acute cerebral infarction with adenomyosis in a young woman: a case report

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