Endocarditis: the great mimic of rheumatic diseases

Misra, Durga Prasanna; Chowdury, Abhra Chandra; Edavalath, Sukesh; Aggarwal, Amita; Kumar, Sudeep; Agarwal, Vikas

doi:10.1177/0049475515624031

Cited by 9 publications

(6 citation statements)

References 17 publications

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“…Congestive heart failure constitutes an independent predictor of mortality (58). A few investigators have suggested that ANCA-negative status in patients with eosinophilic granulomatosis with polyangiitis is a risk factor for cardiac involvement (59). Cardiomyopathy is the most common pattern of cardiac involvement in patients with eosinophilic granulomatosis with polyangiitis and is seen in 30% of cases.…”

Section: Eosinophilic Granulomatosis With Polyangi-mentioning

confidence: 99%

“…Aortic insufficiency is the most common valvular manifestation, followed by mitral regurgitation and aortic stenosis. Endocardial masses also have been described, mimicking primary infectious endocarditis (59,64).…”

Section: Granulomatosis With Polyangiitis and Microscopicmentioning

confidence: 99%

“…Cogan syndrome rarely affects the heart, with only a few such cases reported in the literature. Cogan syndrome produces aortic root dilatation, aortic and mitral regurgitation, and coronary artery vasculitis, with resultant ischemic heart disease and congestive heart failure (59).…”

Section: Variable Vessel Vasculitismentioning

confidence: 99%

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CT and MR Imaging of Cardiothoracic Vasculitis

Broncano¹,

Vargas²,

Bhalla³

et al. 2018

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The term vasculitis includes a variable group of entities in which the common characteristic is inflammation of the walls of blood vessels occurring at some time during the course of the disease. The vasculitides can be divided into primary and secondary vasculitides, depending on the etiology and according to the size of the vessel affected. Both primary vasculitis and secondary vasculitis are associated with cardiac morbidity that is often subclinical. Cardiac involvement is associated with prognostic implications and higher rates of related mortality. Vasculitis of cardiac structures and the assessment of disease extent are important for appropriate management and selection of treatment. Although echocardiography, radionuclide imaging, and catheter-directed coronary angiography remain the cornerstones of cardiac imaging, cardiac computed tomography and magnetic resonance imaging can offer a 360° assessment of cardiac anatomy, function, and complications secondary to vasculitis. Postoperative complications, which are more frequent in patients with active disease, can also be depicted with those imaging modalities. A multidisciplinary approach is important to yield an appropriate estimate of the disease activity and extent and, therefore, to enable better treatment selection and monitoring. Online supplemental material is available for this article. RSNA, 2018.

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Section: Eosinophilic Granulomatosis With Polyangi-mentioning

confidence: 99%

Section: Granulomatosis With Polyangiitis and Microscopicmentioning

confidence: 99%

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CT and MR Imaging of Cardiothoracic Vasculitis

Broncano¹,

Vargas²,

Bhalla³

et al. 2018

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“…Clinical manifestations suggesting an autoimmune disease can appear in 25-42% patients with infective endocarditis, and may include arthritis, muscle and joint pain, sacroiliitis, leukocytoclastic cutaneous vasculitis and glomerulonephritis. [2][3][4] In up to 60% of the cases, the presence of hypocomplementaemia, rheumatoid factor, ANA, anti-neutrophil cytoplasma antibodies or aPL antibodies has been reported. 5,6…”

Section: Letter To the Editormentioning

confidence: 99%

All that glitters is not lupus

López-Mato

Zamora‐Martínez

Carbajal

et al. 2017

Lupus

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“…However, superantigens induced by some bacteria, such as Staphylococcus aureus , can stimulate an immune response, which could interfere with antibody production 4. Rheumatic manifestations, such as myalgia, arthralgia and arthritis are prevalent, occurring in nearly 40% of patients with IE at presentation of weeks to months before the diagnosis of IE 5. When classic IE manifestations are less evident, patients can be misdiagnosed as having a rheumatological disease, which might lead to delayed initiation of antibiotic treatment.…”

Section: Introductionmentioning

confidence: 99%

Clinical characteristics of infective endocarditis in patients with antineutrophil cytoplasmic antibody or antiphospholipid antibody: a retrospective study in Shanghai

Zhou

Teng

et al. 2020

BMJ Open

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ObjectiveThis study aimed to characterise rheumatic manifestations and autoantibodies in 432 patients diagnosed with infective endocarditis (IE) in Shanghai.Design, setting and participantsA retrospective study was conducted in Ruijin Hospital from 1997 to 2017. The clinical and laboratory characteristics of a total of 432 patients were analysed. In addition, the differences between patients with positive and negative antineutrophil cytoplasmic antibodies (ANCA) and antiphospholipid (aPL) antibodies as well as the survival rates of these patients were compared.ResultsA total of 432 patients, including 278 male patients and 154 female patients, were included. The mean age of the patients was 46±16 years. A total of 346 patients (80%) had cardiac surgery, and 55 patients (13%) died in the hospital. Among the IE patients, 104 were tested for either ANCA or aPL and were analysed in different groups. Twenty-one (24%) positive ANCA patients were proteinase 3-ANCA positive. Compared with the ANCA-negative group, patients with positive ANCA had higher IgM (p=0.048), lower haemoglobin (p=0.001) and a higher likelihood of arthritis (p=0.003). Twenty-one (40%) aPL-positive patients had a higher erythrocyte sedimentation rate than was found in the aPL-negative group (p=0.003). In addition, the survival rate of the ANCA-positive IE patients was lower (p=0.032) than that of the ANCA-negative group, while there was no difference between patients with or without aPL antibodies (p=0.728).ConclusionThis study supports the claim that rheumatic manifestations and autoantibodies are frequently present in patients with IE and might lead to early misdiagnosis. Physicians should pay more attention to the measurement of autoantibodies in these patients.

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Endocarditis: the great mimic of rheumatic diseases

Cited by 9 publications

References 17 publications

CT and MR Imaging of Cardiothoracic Vasculitis

CT and MR Imaging of Cardiothoracic Vasculitis

All that glitters is not lupus

Clinical characteristics of infective endocarditis in patients with antineutrophil cytoplasmic antibody or antiphospholipid antibody: a retrospective study in Shanghai

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