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Malignancy And Anticoagulation
Published in Genesio Murano, Rodger L. Bick, Basic Concepts of Hemostasis and Thrombosis, 2019
Fisher et al.16 have reported four cases of recurrent thrombophlebitis in patients on anticoagulants, all of whom, at a later date, developed lung carcinoma as their primary disease. This was not suspected at the time of the initial episodes of thromboses. Roh-ner et al.17 have reported on a series of patients with nonbacterial thrombotic endocarditis. Unfortunately, most of these were diagnosed postmortem, as they all had the sysmptoms of endocarditis, but all had multiple negative blood cultures. This syndrome is seen primarily in patients with mucous-producing carcinomas that include carcinoma of the stomach and lung, as well as pancreas, and also in patients with anaplastic tumors. Cowan and Haut,18 reporting on patients with acute leukemia, found that the platelet surface reactivity and release mechanism appear to be defective, since bleeding was not related to the platelet count.
Infective Endocarditis
Published in P. Chopra, R. Ray, A. Saxena, Illustrated Textbook of Cardiovascular Pathology, 2013
Fig. 5.30: Nonbacterial thrombotic endocarditis. Large reddish vegetations are seen on the atrial aspect of the posterior and part of the anterior leaflet of the mitral valve. The vegetations are present on the contact margin of the leaflets. Spleen and kidney showed multiple healed infarcts
Collapse of the Lung
Published in K. Gupta, P. Carmichael, A. Zumla, 100 Short Cases for the MRCP, 2020
K. Gupta, P. Carmichael, A. Zumla
There are several paraneoplastic syndromes that can occur with bronchial carcinoma. The most common group is that associated with endocrine abnormalities, for example: PTH-related peptide production by squamous cell carcinoma.The syndrome of inappropriate ADH production by small cell carcinoma.Non-endocrine associations include: Hypertrophic pulmonary osteopathy usually associated with adenocarcinomas.Neurologic-myopathic syndromes including the EatonLambert syndrome.Peripheral neuropathies.Subacute cerebellar degeneration.Polymyositis.A significant proportion, 1-8% may suffer from migratory venous thrombophlebitis.Non-bacterial thrombotic endocarditis.DIC.Cutaneous manifestations may include dermatomyositis and acanthosis nigricans.Renal manifestations may include the nephrotic syndrome or glomerulonephritis.
Active NET formation in Libman–Sacks endocarditis without antiphospholipid antibodies: A dramatic onset of systemic lupus erythematosus
Published in Autoimmunity, 2018
Daniel Appelgren, Charlotte Dahle, Jasmin Knopf, Rostyslav Bilyy, Volodymyr Vovk, Pia C. Sundgren, Anders A. Bengtsson, Jonas Wetterö, Luis E. Muñoz, Martin Herrmann, Anders Höög, Christopher Sjöwall
Non-bacterial thrombotic endocarditis (NBTE) constitutes a pathologic entity of sterile vegetative endocarditis, which is found in up to 4% of autopsies [14]. Formation of these vegetations has been reported in association with several systemic conditions, including malignancies, severe burns, and states of hypercoagulation [14,15]. The term Libman–Sacks endocarditis refers to a specific subclass of NBTE which almost exclusively affects individuals with antiphospholipid autoantibodies (aPLs), that is, primary or secondary antiphospholipid syndrome (APS) [16]. The vegetations found in Libman–Sacks endocarditis range in size from microscopic to large and verrucous and consist of platelet-fibrin thrombi, immune complexes and mononuclear cells [17,18].
Recurrent nonbacterial thrombotic endocarditis and stroke on anticoagulation
Published in Journal of Community Hospital Internal Medicine Perspectives, 2020
Sijan Basnet, Thomas Stauffer, Amar Jayswal, Biswaraj Tharu
Nonbacterial thrombotic endocarditis (NBTE), usually discovered postmortem, is a rare noninfectious cause of endocarditis and is characterized by fibrinoplatelet deposition on heart valves [1,2]. Its prevalence ranges between 0.3% and 9.3% [1]. NBTE is most commonly associated with primary antiphospholipid syndrome (APS), malignancy, hypercoagulable states, and systemic lupus erythematosus (SLE) [2,3]. NBTE in the setting of APS or SLE is also called Libman-Sacks endocarditis [4]. We present a rare case of recurrent NBTE characterized by mitral valve endocarditis complicated by stroke despite therapeutic anticoagulation in the setting of primary APS and previous aortic valve endocarditis status post aortic valve replacement.