Ghasem Farahmand¹, Nina Javadian¹, Hanna Magrouni¹, Rozita Amiri¹ and Mojdeh Ghabaee²*

¹Neurologist, Iranian Center of Neurological Research, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
²Professor of Neurology, Sabbatical in Stroke, Iranian Center of Neurological Research, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran

*Corresponding Author: Mojdeh Ghabaee, Professor of Neurology, Sabbatical in Stroke, Iranian Center of Neurological Research, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran.

Received: December 15, 2022; Published: March 07, 2023

Abstract

This is report of 27 years old lady admitted with acute onset aphasia, right sided hemiparesis and facial paresis without of previous history of Cardiac or other atherosclerotic risk factors, abortions, rheumatologic disorder, thrombotic events. Ischemic in right MCA territory and right frontal lobe signal change in favor of cortical subarachnoid hemorrhage were the findings in MRI.

Positive Antiphospholipid antibody associated with mitral valve vegetation, suggestive of Nonbacterial thrombotic endocarditis (NBTE) in Trans-Esophageal Echocardiogram (TEE) were the positive finding in evaluation. So with diagnosis of NBE in the setting of antiphosholipid antibody, anticoagulant therapy was started. Screening for Malignancy were negative.

NBTE also known as Libman-Sacks Endocarditis, Marantic Endocarditis, is a rare condition according to autopsy series ranging from 0.9 to 1.6 percent. It has been reported in every age group, most commonly affecting patients between the fourth and eighth decades of life with no sex predilection. Mucus secreting malignancy, systemic lupus erythematosus and APS syndrome are the common etiologies.

Keywords: Juvenile Stroke; Antiphospholipid Syndrome; Libman-Sacks Endocarditis; NBTE

References

1. González AQ., et al. “Non-bacterial thrombotic endocarditis in cancer patients”. Acta Cardiologica 1 (1991): 1-9.
2. El-Shami K., et al. “Nonbacterial thrombotic endocarditis in cancer patients: pathogenesis, diagnosis, and treatment”. Oncologist 5 (2007): 518.
3. Roldan CA., et al. “Transthoracic versus transesophageal echocardiography for detection of Libman-Sacks endocarditis: a randomized controlled study”. The Journal of Rheumatology 2 (2008): 224-229.
4. Kitagawa Y., et al. “Stroke in systemic lupus erythematosus”. Stroke11 (1990): 1533-1539.
5. Malvar B., et al. “Cerebral embolism from Libman-Sacks endocarditis”. BMJ Case Reports (2011).
6. Cuvinciuc V., et al. “Isolated acute nontraumatic cortical subarachnoid hemorrhage”. American Journal of Neuroradiology8 (2010): 1355-1362.
7. Gromnica-Ihle E and W Schossler. “Antiphospholipid syndrome”. International Archives of Allergy and Immunology 1 (2000): 67-76.
8. Turiel M., et al. “Five-year follow-up by transesophageal echocardiographic studies in primary antiphospholipid syndrome”. American Journal of Cardiology 4 (2005): 574-579.
9. Okuma H., et al. “Comparison between single antiplatelet therapy and combination of antiplatelet and anticoagulation therapy for secondary prevention in ischemic stroke patients with antiphospholipid syndrome”. International Journal of Medical Sciences 1 (2009): 15-18.
10. Fluture A., et al. “Valvular heart disease and systemic lupus erythematosus: therapeutic implications”. Heart Disease5 (2003): 349-353.
11. et al. “Comparing effectiveness of four preventive methods of drug abuse on self-esteem and attitude to addiction in students of educational, cultural and dormitory complexes of Imam Khomeini Relief commission”. Journal of Addiction Research 21 (2012): 35-46.

Citation

Citation: Mojdeh Ghabaee., et al. “Primary Antiphospholipid Syndrome: A Case Report of Embolic Ischemic Stroke and Cortical SAH due to Libman-Sacks Endocarditis". Acta Scientific Neurology 6.4 (2023): 13-15.

Copyright

Copyright: © 2023 Mojdeh Ghabaee., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.