Document Detail

Diffuse alveolar hemorrhage and Libman-Sacks endocarditis as a manifestation of possible primary antiphospholipid syndrome.
MedLine Citation:
PMID:  23340096     Owner:  NLM     Status:  MEDLINE    
Antiphospholipid syndrome (APS) is an autoimmune disease characterized by the presence of circulating autoantibodies against phospholipid-binding plasma proteins, leading to an increased risk of thrombosis and pregnancy loss. The most common manifestation of lung disease in APS is pulmonary embolism, which may often be the presenting symptom. We present a 30-year-old man with probable primary APS (with no history of thromboses) presenting with diffuse alveolar hemorrhage, an uncommon presentation. He was also found to have severe mitral valve regurgitation and during valve replacement surgery had cardiac vegetations compatible with a presentation of Libman-Sacks endocarditis. There are only 21 other reported cases of diffuse alveolar hemorrhage occurring as a result of APS. This is the first case of Libman-Sacks endocarditis in the setting of probable APS and alveolar hemorrhage.Diffuse alveolar hemorrhage should be considered as a nonthrombotic manifestation of APS, even in the absence of known thromboses, and may be the presenting symptom.
Roodabeh Michelle Koolaee; Anna M Moran; Anupama Shahane
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Journal of clinical rheumatology : practical reports on rheumatic & musculoskeletal diseases     Volume:  19     ISSN:  1536-7355     ISO Abbreviation:  J Clin Rheumatol     Publication Date:  2013 Mar 
Date Detail:
Created Date:  2013-02-21     Completed Date:  2013-07-30     Revised Date:  2013-09-17    
Medline Journal Info:
Nlm Unique ID:  9518034     Medline TA:  J Clin Rheumatol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  79-83     Citation Subset:  IM    
Division of Rheumatology, University of Pennsylvania, Philadelphia, PA, USA.
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MeSH Terms
Antiphospholipid Syndrome / diagnosis*,  drug therapy
Endocarditis, Non-Infective / diagnosis*
Heart Valve Prosthesis Implantation
Hemoptysis / etiology
Hemorrhage / diagnosis*
Lung Diseases / diagnosis*
Mitral Valve / pathology,  surgery
Mitral Valve Insufficiency / diagnosis*,  surgery
Pulmonary Alveoli*
Tomography, X-Ray Computed
Comment In:
J Clin Rheumatol. 2013 Aug;19(5):300   [PMID:  23884191 ]
J Clin Rheumatol. 2013 Aug;19(5):301   [PMID:  23884192 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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