Libman-Sacks endocarditis
Encyclopedia
Libman-Sacks endocarditis is a form of nonbacterial endocarditis
Endocarditis
Endocarditis is an inflammation of the inner layer of the heart, the endocardium. It usually involves the heart valves . Other structures that may be involved include the interventricular septum, the chordae tendineae, the mural endocardium, or even on intracardiac devices...

 that is seen in systemic lupus erythematosus
Lupus erythematosus
Lupus erythematosus is a category for a collection of diseases with similar underlying problems with immunity . Symptoms of these diseases can affect many different body systems, including joints, skin, kidneys, blood cells, heart, and lungs...

. It is one of the most common cardiac manifestations of lupus (the most common being pericarditis).

It was first described by Drs. Emanuel Libman and Benjamin Sacks at Mount Sinai Hospital
Mount Sinai Hospital, New York
Mount Sinai Hospital, founded in 1852, is one of the oldest and largest teaching hospitals in the United States. In 2011-2012, Mount Sinai Hospital was ranked as one of America's best hospitals by U.S...

 in New York City
New York City
New York is the most populous city in the United States and the center of the New York Metropolitan Area, one of the most populous metropolitan areas in the world. New York exerts a significant impact upon global commerce, finance, media, art, fashion, research, technology, education, and...

 in 1924. The association between Libman-Sacks endocarditis and antiphospholipid syndrome
Antiphospholipid syndrome
Antiphospholipid syndrome or antiphospholipid antibody syndrome , often also Hughes syndrome, is an autoimmune, hypercoagulable state caused by antibodies against cell-membrane phospholipids that provokes blood clots in both arteries and veins as well as pregnancy-related complications such as...

 was first noted in 1985.

Presentation

The vegetation
Vegetation (pathology)
In medicine, a vegetation is an abnormal growth named for its similarity to natural vegetation.Vegetations are often associated with endocarditis.It can be made of fibrin and platelets.-Types:...

s are small and formed from strands of fibrin
Fibrin
Fibrin is a fibrous, non-globular protein involved in the clotting of blood. It is a fibrillar protein that is polymerised to form a "mesh" that forms a hemostatic plug or clot over a wound site....

, neutrophils, lymphocytes, and histiocyte
Histiocyte
A histiocyte is a cell that is part of the mononuclear phagocyte system . The mononuclear phagocytic system is part of the organism's immune system...

s. The mitral valve
Mitral valve
The mitral valve is a dual-flap valve in the heart that lies between the left atrium and the left ventricle...

 is typically affected, and the vegetations occur on the ventricular and atrial surface of the valve. Libman-Sacks lesions rarely produce significant valve dysfunction and the lesions only rarely embolize.

Pathology

The pathology is the same as nonbacterial thrombotic endocarditis except focal necrosis (hematoxylin bodies) can be found only in Libman-Sacks endocarditis.
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