Nonbacterial thrombotic endocarditis
| Nonbacterial thrombotic endocarditis | |
|---|---|
| Classification and external resources | |
| Specialty | Lua error in Module:Wikidata at line 446: attempt to index field 'wikibase' (a nil value). |
| DiseasesDB | 29250 |
| Patient UK | Nonbacterial thrombotic endocarditis |
Non-bacterial thrombotic endocarditis (NBTE) is a form of endocarditis in which small sterile vegetations are deposited on the valve leaflets. Formerly known as marantic endocarditis, which comes from the Greek marantikos, meaning “wasting away.”[1] The term "marantic endocarditis" is still sometimes used to emphasize the association with a wasting state[2] such as cancer.[3]
Histopathology
Grossly, vegetations form along lines of valve closure and are generally symmetric with a smooth or verrucoid (warty) texture. Histologically, lesions are composed of fibrin[4] (eosinophilic) and platelets but, unlike bacterial etiologies, contain little evidence of PMNs, microorganisms or inflammation.
Risk factors
Marantic vegetations are often associated with previous rheumatic fever.
Other risk factors include:
- hypercoagulable states
- malignant cancers, especially mucin-producing adenocarcinomas (most commonly associated with pancreatic adenocarcinomas)
- systemic lupus erythematosus: Referred to as Libman-Sacks endocarditis
- trauma (e.g., catheters)
Valve predilection
The disease affects the valves with the following predilection:
aortic valve > mitral valve > tricuspid valve > pulmonary valve [5]
Diagnosis
Due to the non-invasive nature of NBTE, clinical examination may or may not reveal a new murmur.
An embolic stroke may be the first feature to suggest the diagnosis of NBTE. An echocardiograph may be used to further assess for valvular lesions.
References
- ↑ Neurological Sequelae of Infectious Endocarditis at eMedicine
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- ↑ Lua error in package.lua at line 80: module 'strict' not found.
- ↑ "nonbacterial thrombotic endocarditis" at Dorland's Medical Dictionary
- ↑ Lua error in package.lua at line 80: module 'strict' not found.
