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Pol. Merkur. Lek (Pol. Med. J.), 2016, XL/237: 182-185 Maximize

Pol. Merkur. Lek (Pol. Med. J.), 2016, XL/237: 182-185

Title: Non-bacterial thrombotic endocarditis on the bicuspid aortic valve in a 25-year-old male with lupus anticoagulant 

Authors: Elikowski W, Jarząbek R, Małek M, Witczak W, Łazowski S, Psuja P. 

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SUMMARY IN POLISH & ENGLISH. FULL ARTICLE ONLY IN POLISH.

Non-bacterial thrombotic endocarditis on the bicuspid aortic valve in a 25-year-old male with lupus anticoagulant


Elikowski W1, Jarząbek R2, Małek M3, Witczak W1, Łazowski S4, Psuja P1.

Józef Struś Hospital, Poznań, Poland: 1Department of Internal Medicine; 2Department of Cardiac Surgery; 4Pathomorphlogy Unit; 3Karol Marcinkowski Medical University of Poznań, Poland, 2nd Department of Cardiology

Non-bacterial thrombotic endocarditis (NBTE) is characterized by presence of sterile vegetations that develop from fibrin and platelets on heart valves. The main conditions predisposing to NBTE are malignancy, autoimmune diseases and other hypercoagulable states. The authors describe a case of a 25-year-old male, in whom NBTE was diagnosed on the bicuspid aortic valve. The presence of significant aortic regurgitation and dental caries were initially suggestive of infective endocarditis; although, serial blood culture were negative and procalcytonin concentration was within normal ranges. Empiric antibiotic therapy did not result in diminishing of vegetations, similarly to the anticoagulation treatment initiated when strongly positive lupus anticoagulant was detected in laboratory findings. Aortic valve replacement was necessary. Bacteriologic examination of the excised valve was negative. Widespread fibrin masses at different stages of organization on the leaflets confirmed NBTE in histopathologic assessment. Lupus anticoagulant was probably secondary to thyroid autoimmune disease.

Key words: non-bacterial thrombotic endocarditis, bicuspid aortic valve, lupus anticoagulant

Pol Med J, 2016; XL (237); 182–185