Al Riyami Hilal, Joshi Niranjan, Al Senaidi Khalfan, Al 'Abdul Salam Noof, Abdwani Reem
Department of Child Health, Sultan Qaboos University Hospital, Muscat, OMN.
Department of Child Health, Oman Medical Specialty Board, Muscat, OMN.
Cureus. 2022 Jul 3;14(7):e26526. doi: 10.7759/cureus.26526. eCollection 2022 Jul.
Libman-Sacks endocarditis (LSE) is an uncommon disorder that might be confused with infective endocarditis. It is one of the systemic lupus erythematosus (SLE) manifestations that could present with heart failure. We report a 12-year-old girl who presented with a history of shortness of breath, joint pain for four weeks, and fever for about one week. On examination, she was pale, edematous, and febrile. Her cardiac exam revealed a pan-systolic murmur of mitral regurgitation, harsh, grade 3/6 best heard at the apex. She was diagnosed with systemic lupus erythematosus with lupus nephritis and carditis. Her echocardiography revealed severe mitral regurgitation with nodular thickening of the valve in keeping with a diagnosis of LSE. After appropriate management of her underlying disorder using immunosuppressive, we saw a dramatic clinical improvement and her heart failure symptoms resolved. This case proves that SLE can have significant cardiac involvement and a proper evaluation would help in overall management and prognosis.
利布曼-萨克斯心内膜炎（LSE）是一种罕见的疾病，可能会与感染性心内膜炎相混淆。它是系统性红斑狼疮（SLE）的表现之一，可伴有心力衰竭。我们报告一名12岁女孩，有气短病史4周、关节疼痛4周、发热约1周。检查时，她面色苍白、水肿且发热。心脏检查发现二尖瓣反流的全收缩期杂音，粗糙，3/6级，在心尖部最易听到。她被诊断为系统性红斑狼疮伴狼疮性肾炎和心肌炎。她的超声心动图显示严重二尖瓣反流，瓣膜有结节状增厚，符合LSE的诊断。在使用免疫抑制剂对其基础疾病进行适当治疗后，我们看到了显著的临床改善，她的心力衰竭症状得到缓解。该病例证明SLE可伴有严重的心脏受累，适当的评估有助于整体管理和预后。
