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Case Reports
. 2022 Jul 3;14(7):e26526.
doi: 10.7759/cureus.26526. eCollection 2022 Jul.

All Endocarditis Is Not Infective: Libman-Sacks Endocarditis

Hilal Al Riyami  1 , Niranjan Joshi  1 , Khalfan Al Senaidi  1 , Noof Al 'Abdul Salam  2 , Reem Abdwani  3
Affiliations
Case Reports

All Endocarditis Is Not Infective: Libman-Sacks Endocarditis

Hilal Al Riyami et al. Cureus. .

Abstract

Libman-Sacks endocarditis (LSE) is an uncommon disorder that might be confused with infective endocarditis. It is one of the systemic lupus erythematosus (SLE) manifestations that could present with heart failure. We report a 12-year-old girl who presented with a history of shortness of breath, joint pain for four weeks, and fever for about one week. On examination, she was pale, edematous, and febrile. Her cardiac exam revealed a pan-systolic murmur of mitral regurgitation, harsh, grade 3/6 best heard at the apex. She was diagnosed with systemic lupus erythematosus with lupus nephritis and carditis. Her echocardiography revealed severe mitral regurgitation with nodular thickening of the valve in keeping with a diagnosis of LSE. After appropriate management of her underlying disorder using immunosuppressive, we saw a dramatic clinical improvement and her heart failure symptoms resolved. This case proves that SLE can have significant cardiac involvement and a proper evaluation would help in overall management and prognosis.

Keywords: endocarditis; heart failure.; libman-sacks endocarditis; mitral valve; systemic lupus erythematosus.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Echocardiography (Apical four-chamber view showing thick anterior mitral leaflet)
Figure 2
Figure 2. Echocardiography (Apical four-chamber view showing severe mitral regurgitation)
Figure 3
Figure 3. Echocardiography (Apical four-chamber view showing mild Mitral regurgitation)
See this image and copyright information in PMC

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