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Rheumatology Commons

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Full-Text Articles in Rheumatology

Nonbacterial Thrombotic Mitral Valve Endocarditis Presenting As Embolic Stroke In A Young Patient With Lupus And Anti-Phospholipid Syndrome, Andrew Mccuen, Muhammad Saad, Erin Jm Terpstra, Adam T. Stys Jul 2021

Nonbacterial Thrombotic Mitral Valve Endocarditis Presenting As Embolic Stroke In A Young Patient With Lupus And Anti-Phospholipid Syndrome, Andrew Mccuen, Muhammad Saad, Erin Jm Terpstra, Adam T. Stys

Aesculapius Journal (Health Sciences & Medicine)

A 37-year-old man on systemic immunosuppression for clinically and biochemically quiescent lupus nephritis, presented with left hemiparesis. Brain MRI was concerning for right sided embolic stroke. Workup was negative for atrial fibrillation, deep venous thrombosis, and heart failure. Transesophageal echocardiogram was remarkable for fixed mitral valve leaflet echodensities. In the absence of bacteremia and systemic signs of infection, and with a history of lupus, small vegetations on atrial and ventricular sides of mitral valve leaflets are suggestive of nonbacterial thrombotic endocarditis. Nonbacterial thrombotic vegetations are composed of fibrin deposits on otherwise-healthy valves. Mainstay of treatment is therapeutic anticoagulation with clinical …


Multi-Digit Auto-Amputation In Setting Of Mixed Connective Tissue Disease, Kishan P. Patel, Jennifer L. Medlin, Michelene Hearth-Holmes Dec 2020

Multi-Digit Auto-Amputation In Setting Of Mixed Connective Tissue Disease, Kishan P. Patel, Jennifer L. Medlin, Michelene Hearth-Holmes

Graduate Medical Education Research Journal

Raynaud’s disease is a cutaneous manifestation often present in various connective tissue and vascular diseases. Depending on the age of onset and acuity of symptoms, the phenomenon can provide clinicians with some insight as to the severity of underlying disease, including the distinction between primary and secondary Raynaud’s. However, this diagnostic approach seems to have its limitations regarding efficacy and timing of treatment. Traditionally, treatment of Raynaud’s has focused on reestablishing blood perfusion to affected tissue, which has previously been achieved with vasodilatory medications and site-specific surgical intervention. In lieu of the severe sequelae of Raynaud’s in the setting of …