Nonbacterial thrombotic endocarditis in a patient with gastric cancer and SARS-CoV-2 infection

Binet, Quentin; Goffinet, Céline; Etogo-Asse, Frédérique-Estelle; Shaza, Leila

doi:10.1007/s12328-021-01412-8

Cited by 6 publications

(5 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…We found, however, a case of known gastric cancer and acute SARS-CoV-2 infection presenting with multiple ischemic strokes complicating a non-bacterial thrombotic mitral endocarditis. 15 In our case, a paraneoplastic prothrombotic state was suspected based on markedly elevated d-dimers, the three-territory sign, and recurrent ischemic events while on appropriate therapeutic anticoagulation. Other weaker markers of systemic in ammation (slightly elevated CRP, mild unexplained anemia) and increased cell turnover (slightly elevated LDH) were present.…”

Section: Discussionmentioning

confidence: 82%

“…There are at least ve published scores to help identify people who may bene t from more extensive cancer screening. 1,10,13,14,15 None of them, however, are externally validated and all were developed from retrospective, single-center studies. Four of them included both occult and treated cancers, lumping together two distinct stroke risk pro les related to cancer treatments (eg, radiotherapy, chemotherapy).…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

WITHDRAWN: Paraneoplastic Prothrombotic State Causing Recurrent Ischemic Stroke ; a case report

Rivest

Rioux

Lanthier

et al. 2023

Preprint

View full text Add to dashboard Cite

Background This case report is a good example of when to suspect a paraneoplastic prothrombotic state (PPS) as a cause of ischemic stroke (IS). Many clinical, laboratory and imaging features linked to PPS are well illustrated in this patient. Case presentation A 78 years old patient, known for a single 2x1,5cm middle lobe lung nodule who was on apixaban 5mg BID for documented pulmonary embolisms in his latest hospitalization, was admitted to the stroke unit for left-sided hemianopia and hemineglect. Brain MRI showed multifocal acute and subacute infarcts involving the anterior and posterior cerebral arteries and the right cerebellum. The standard stroke work-up were unremarkable beside a mild normocytic anemia (122 g/L) and a high d-dimers level. The patient returned to the hospital, eleven days after discharge for new left MCA infarcts confirmed by head CT. At this point, D-dimers were still very high (>4,400 ng/ml), C-reactive protein was slightly increased (14 mg/L) and there was still a mild inflammatory anemia. Cancer work-up was started and confirmed a stage III lung adenocarcinoma. Conclusion In this stroke patient, an etiological diagnosis of PPS was supported by the presence of a lung nodule, negative standard neurovascular workup, stroke recurrence (despite anticoagulation), infarcts in multiple vascular territories, and markers of systemic inflammation (anemia, high CRP) and active fibrinolysis (high d-dimers). This etiology should be considered in IS patients presenting with those PPS markers.

show abstract

Section: Discussionmentioning

confidence: 82%

Section: Discussionmentioning

confidence: 99%

WITHDRAWN: Paraneoplastic Prothrombotic State Causing Recurrent Ischemic Stroke ; a case report

Rivest

Rioux

Lanthier

et al. 2023

Preprint

View full text Add to dashboard Cite

show abstract

“…Among 829 searched studies, 121 studies [ 19 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 , 75 , 76 , 77 , 78 ...…”

Section: Resultsunclassified

Lung Cancer as a Leading Cause among Paraneoplastic Non-Bacterial Thrombotic Endocarditis: A Meta-Analysis of Individual Patients’ Data

Rahouma

Khairallah

Dabsha

et al. 2023

Cancers

View full text Add to dashboard Cite

Hypercoagulability is strongly associated with cancer and may result in non-bacterial thrombotic endocarditis (NBTE). The aim of our meta-analysis was to explore the demographics and characteristics of this condition in cancer. Databases were systematically searched. The outcomes were to identify the annual trend in premortem diagnosis among the entire cohort and different subgroups and to identify differences in characteristics and survival in the considered population. A total of 121 studies with 144 patients were included. The proportion of marantic endocarditis associated with lung cancer was 0.29 (95% CI, 0.21–0.37; p < 0.001), that associated with pancreatic cancer was 0.19 (95% CI, 0.13–0.27; p < 0.001), that associated with advanced cancer stage (metastasis) was 0.69 (95% CI, 0.61–0.76; p < 0.001), and that associated with adenocarcinoma was 0.65 (95% CI, 0.56–0.72; p < 0.001). Median and 6-month overall survival (OS) were 1.3 months and 32.3%, respectively, with 6-month OS of 20.8% vs. 37.0% in lung vs. other cancers, respectively (p = 0.06) and 42.9% vs. 31.1% among those who underwent intervention vs. those who did not (p = 0.07). Cases discovered in recent years had better survival (HR = 0.98 (95% CI, 0.96–0.99; p = 0.003). While cancer-associated NBTE is a rare entity, lung cancers were the most common tumor site and are frequently associated with more advanced and metastatic cancer stages. The prognosis is dismal, especially among lung cancers.

show abstract

“…100 101 A nonbacterial thrombotic endocarditis occurring in the setting of concurrent gastric cancer and COVID-19 resulted in homonymous hemianopia, leading the authors to hypothesize a role of the infection in the endocarditis. 102 A COVID-19 patient presenting with right homonymous hemianopia was found to have simultaneous cerebral VST (CVST) and immune thrombocytopenic purpura, a unique occurrence. 103…”

Section: Cortical Vision Lossmentioning

confidence: 99%

Neuro-Ophthalmic Visual Impairment in the Setting of COVID-19

Dinkin

Sathi

2023

Semin Neurol

View full text Add to dashboard Cite

We set out to describe in detail the afferent neuro-ophthalmological complications that have been reported in association with coronavirus disease 2019 (COVID-19) infection. We describe and elaborate on mechanisms of disease, including para-infectious inflammation, hypercoagulability, endothelial damage, and direct neurotropic viral invasion. Despite global vaccination programs, new variants of COVID-19 continue to pose an international threat, and patients with rare neuro-ophthalmic complications are likely to continue to present for care.Afferent complications from COVID-19 include homonymous visual field loss, with or without higher cortical visual syndromes, resulting from stroke, intracerebral hemorrhage, or posterior reversible leukoencephalopathy. Optic neuritis has frequently been reported, sometimes along with acute disseminated encephalomyelopathy, often in association with either myelin oligodendrocyte glycoprotein antibodies (MOG-IgG) or less commonly aquaporin-4 seropositivity or in newly diagnosed multiple sclerosis. Ischemic optic neuropathy has rarely been reported. Papilledema, resulting either from venous sinus thrombosis or idiopathic intracranial hypertension in the setting of COVID-19, has also been described.Observed afferent neuro-ophthalmic associations need to be confirmed though larger comparative studies. Meanwhile, the range of possible complications should be recognized by neurologists and ophthalmologists alike, to facilitate faster diagnosis and treatment of both COVID-19 and its neuro-ophthalmic manifestations.

show abstract

Nonbacterial thrombotic endocarditis in a patient with gastric cancer and SARS-CoV-2 infection

Cited by 6 publications

References 15 publications

WITHDRAWN: Paraneoplastic Prothrombotic State Causing Recurrent Ischemic Stroke ; a case report

WITHDRAWN: Paraneoplastic Prothrombotic State Causing Recurrent Ischemic Stroke ; a case report

Lung Cancer as a Leading Cause among Paraneoplastic Non-Bacterial Thrombotic Endocarditis: A Meta-Analysis of Individual Patients’ Data

Neuro-Ophthalmic Visual Impairment in the Setting of COVID-19

Contact Info

Product

Resources

About