Aseptic Vegetation in Pulmonary Artery Valve, Finding in a Patient with Systemic Lupus Erythematosus. Case report

Abstract

Systemic lupus erythematosus (SLE) is an entity that promotes the formation of autoantibodies that trigger immune complexes that damage various organs of the body. Worldwide, SLE has a prevalence of 13-7000 per 100,000 people and leads to a high mortality from cardiovascular diseases, as well as the risk of developing lupus nephritis (LN) in 60% of cases. We present the case of a 41-year-old patient with a history of recently diagnosed arterial hypertension and bronchial hyperreactivity of 20 years of evolution, admitted for 1 month of evolution with asthenia, myalgia, arthralgia and fever; she identifies malar erythematous dermatosis and systolic murmur in a pulmonary focus. When presenting with proteinuria, microhematuria and renal functional impairment, positive ANAs were performed, which is why it was classified as lupus nephropathy, and she needed to start hemodialysis. In the presence of the murmur, an echocardiogram was performed, which showed a pulmonary valve with a 1cm image of vegetation, causing moderate regurgitation. With the diagnosis of Libman-Sacks endocarditis, anticoagulant treatment, steroids, and mycophenolate were started, evolving to normal renal function.