Hemoptysis and a cardiac murmur: is it primary or secondary antiphospholipid syndrome?

Hemoptysis and a cardiac murmur: is it primary or secondary antiphospholipid syndrome? Lupus. 2019 Nov 13;:961203319887229 Authors: Kolitz T, Fruchter O, Sasson L, Geva Y, Moreh-Rahav O, Zandman-Goddard G Abstract Endocarditis is most frequently infective in origin, and thus, when a patient presents with a clinical picture suggestive of endocarditis, an extensive work up aimed at finding the infectious agent is warranted. Among systemic lupus erythematosus (SLE) patients, cardiovascular disease is prevalent in more than 50% of patients including valvular disease and non-infective endocarditis, known as Libman-Sacks (LS) endocarditis. The prevalence of LS syndrome among SLE patients with secondary antiphospholipid syndrome (APS) is higher than in SLE without APS. Here, we present a case of a patient diagnosed with primary APS who presented with hemoptysis and a cardiac murmur. The diagnosis of SLE was established following the findings of non-infective verrucous vegetations together with diffuse alveolar hemorrhage (DAH). Treatment with high-dose corticosteroids and intravenous immunoglobulins yielded substantial resolution of the vegetations and regression of the DAH. Hence, aortic valve replacement was successfully performed as an elective procedure and without any postoperative complications. The patient is in remission after a 6-month follow-up. The clinical findings of DAH and double valve non-infectious endocarditis prompted the diagnosis of SLE wit...
Source: Lupus - Category: Rheumatology Authors: Tags: Lupus Source Type: research

Related Links:

By ANISH KOKA, MD Bobby It took some doing, but I had finally made it to Bobby’s home. It was a rowhome tucked into one of those little side streets in the city that non-city folks wouldn’t dream of driving down. As I step in, I’m met by the usual set up – wooden steps that hug the right side of the wall leading up to the second floor.  Bobby certainly hasn’t made it up to the second floor in some time. At the moment she is sitting in her hospital bed in the living room. The bed is the focal point to a room stuffed to the gills with all manners of stuff. At least three quarters o...
Source: The Health Care Blog - Category: Consumer Health News Authors: Tags: Medical Practice Patients Physicians Anish Koka social injustice Source Type: blogs
In this report, we utilized tissues from prior studies to test the hypothesis that DHA consumption interferes with upregulation of critical genes associated with cSiO2-triggered murine lupus. A NanoString nCounter platform targeting 770 immune-related genes was used to assess the effects cSiO2 on mRNA signatures over time in female NZBWF1 mice consuming control (CON) diets compared to mice fed diets containing DHA at an amount calorically equivalent to human consumption of 2 g per day (DHA low) or 5 g per day (DHA high). Experimental groups of mice were sacrificed: (1) 1 d after a single intranasal instillation of 1 mg cSi...
Source: Frontiers in Immunology - Category: Allergy & Immunology Source Type: research
Lupus nephritis (LN) is one of the most serious manifestations of systemic lupus erythematosus (SLE). Based on studies showing the potential role of heme oxygenase-1 (HO-1), an enzyme that catalyzes the degradation of heme and has anti-inflammatory properties in SLE development, we decided to explore HO-1 in LN. Accordingly, we evaluated HO-1 levels and function in circulating and infiltrating monocytes and neutrophils of LN patients. HO-1 levels were assessed in peripheral monocytes of LN patients and controls by flow cytometry and immunofluorescence microscopy. Phagocytosis and the production of reactive oxygen species (...
Source: Frontiers in Immunology - Category: Allergy & Immunology Source Type: research
Conclusions: The fact that patient disposition varied across different payors suggests that hospitals are missing opportunities to engage the most vulnerable patients with IE. Given the long-term care required by this condition, hospitals are well-positioned to participate in interventions to initiate substance abuse treatment and help patients navigate outpatient substance abuse treatment options.
Source: Medical Care - Category: Health Management Tags: Brief Report Source Type: research
Objective: To compare the functional outcomes and complications of intratympanic gentamicin (ITG) versus intratympanic corticosteroids (ITC) in Menière's disease. Data Sources: An electronic search was conducted in the Cochrane Library, PubMed, and Embase databases on February 3, 2019. Articles written in English, Dutch, German, French, or Turkish language were included. Study Selection: Study inclusion criteria were: 1) patients diagnosed with definite Menière's disease according to the criteria of the American Academy of Otolaryngology-Head and Neck Surgery, 2) treated with ITG or ITC in a compariso...
Source: Otology and Neurotology - Category: ENT & OMF Tags: REVIEW ARTICLES Source Type: research
Condition:   Hypospadias Intervention:   Drug: steroid betamethasone Sponsor:   Cairo University Enrolling by invitation
Source: ClinicalTrials.gov - Category: Research Source Type: clinical trials
This report describes a 48-year-old female with SLE and antiphospholipid syndrome complicated by recurrent thrombosis on anticoagulation. A large left atrial mass lesion was detected on echocardiography during a work-up for leg burning. Infective endocarditis could not be confirmed, and hence left atrial mass lesion was the most likely diagnosis. The patient was managed surgically and the pathology report revealed fibrin networks in a pattern similar to that of thrombosis, characteristic of NBTE.Cardiology 2018;139:208 –211
Source: Cardiology - Category: Cardiology Source Type: research
Clinical introduction A 24-year-old male presented to the emergency department with intense pain in his right lower extremity. He has a medical history significant for systemic lupus erythematosus and antiphospholipid syndrome. He also had four prior episodes of deep venous thromboses on rivaroxaban. The patient stated that early in the morning, he started to feel intense pain that started from his knee and progressed to his calf, with associated numbness and paraesthesia. On physical examination, the limb felt cold with absent right popliteal and dorsalis pedis pulses. He was immediately taken for embolectomy after discov...
Source: Heart - Category: Cardiology Authors: Tags: Drugs: cardiovascular system, Echocardiography, Image challenges, Interventional cardiology, Clinical diagnostic tests Source Type: research
AbstractIntroduction/objectives autoantibodies to types I and IV collagen have been described in rheumatic fever and infective endocarditis. We tried to elucidate if an autoimmune response against collagens I and IV exists, associated with heart valve disease in systemic lupus erythematosus (SLE) and antiphospholipid syndrome (APS). A cohort of 172 patients with SLE (n = 79), primary APS (PAPS,n = 83), and secondary APS (n = 10) were assessed for valvulopathy by transthoracic echocardiograms. Autoantibodies to types I and IV collagen were assessed in patients and 50 controls, setting autoantib...
Source: Clinical Rheumatology - Category: Rheumatology Source Type: research
Janeway lesions and splinter hemorrhages are a cutaneous sign of infective endocarditis (IE). Janeway lesions are nontender, erythematous or violaceous maculae on the palms and/or soles that are also found in several noninfective diseases, such as systemic lupus erythematosus and myxoma. Splinter hemorrhages on multiple nails without any obvious trauma are indicative of systemic causes: not only IE, but antiphospholipid syndrome, vasculitis, and treatment with systemic tyrosine kinase inhibitors or hemodialysis. However, to our knowledge, Janeway lesions or splinter hemorrhages due to noninfective endomyocarditis, such as ...
Source: JAMA Dermatology - Category: Dermatology Source Type: research
More News: Antiphospholipid Syndrome | Cardiology | Cardiovascular | Corticosteroid Therapy | Endocarditis | Heart | Heart Valve Surgery | Hughes Syndrome | Infective Endocarditis | Lupus | Rheumatology