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You are here: Contents > 2013 > Volume 22 Number 1 January 2013 > MITRAL VALVE DISEASE > Antiphospholipid Antibody-Associated Non-Infective Mitral Valve Endocarditis Successfully Treated with Medical Therapy

Antiphospholipid Antibody-Associated Non-Infective Mitral Valve Endocarditis Successfully Treated with Medical Therapy

Tahmeed Contractor, Adrian Bell, Atul Khasnis, Bruce J. Silverberg, Matthew W. Martinez

Division of Cardiology, Lehigh Valley Health Network, Allentown, Pennsylvania, Division of Rheumatology, Cleveland Clinic, Cleveland, Ohio, USA

Non-bacterial endocarditis lesions associated with antiphospholipid antibodies (aPLs) in the absence of other criteria for antiphospholipid syndrome or systemic lupus erythematosus is termed an aPL-associated cardiac valve disease. Evidence regarding the management of this condition is sparse. A rare case is described of a 20-year-old female who presented with an incidental finding of ‘vegetations on a heart valve’. Echocardiography revealed mitral valve leaflet thickening and echodensities with moderate mitral regurgitation. She had an elevated partial thromboplastin time that did not correct with a mixing study, and elevated

levels of antiocardiolipin antibodies. Hence, a diagnosis of aPL-associated cardiac valve disease was made, and the patient commenced on warfarin, hydroxychloroquine, and a short course of oral prednisone. At one year after diagnosis the patient remained symptom-free, and follow up echocardiography revealed resolution of the vegetations with minimal mitral regurgitation. Further evidence is needed to guide the therapy of this rare condition.

The Journal of Heart Valve Disease 2013;22:36-38

Antiphospholipid Antibody-Associated Non-Infective Mitral Valve Endocarditis Successfully Treated with Medical Therapy

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