Nonbacterial thrombotic endocarditis presenting as intracerebral hemorrhage

Wigger, Olivier; Windecker, Stephan; Bloechlinger, Stefan

doi:10.1007/s00508-016-1020-y

Cited by 13 publications

(6 citation statements)

References 15 publications

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“…The vegetations occlude the arterial tree when dislodged. The central nervous system is a frequent site of embolization, leading to ischemic stroke in patients [ 6 , 7 ]. About half of patients with NBTE present with thromboembolic phenomena including stroke [ 8 ].…”

Section: Discussionmentioning

confidence: 99%

“…In patients with malignancy, the interaction between macrophages, monocytes, and malignant cells releases interleukins, tumor necrosis factor, and tissue factor causing endothelial damage, which provides a surface for initiation of platelet aggregation and subsequent hypercoagulability and thrombogenesis [ 2 , 6 , 11 ]. Diagnosis can be made using TTE, or TEE if the diagnosis is missed on TTE.…”

Section: Discussionmentioning

confidence: 99%

“…However, surgery can be considered in patients with thromboembolic events despite undergoing anticoagulant therapy, acute heart failure, or acute valvular rupture. The risk and benefits of surgery should be clearly explained to the patient and the family in the context of the underlying disease prognosis and life expectancy [ 1 , 6 , 14 ].…”

Section: Discussionmentioning

confidence: 99%

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Cancer-Related Non-Bacterial Thrombotic Endocarditis Presenting as Acute Ischemic Stroke

Savarapu¹,

Abdelazeem²,

Isa³

et al. 2021

Cureus

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Non-bacterial thrombotic endocarditis (NBTE), also known as marantic endocarditis, is a rare form of noninfectious endocarditis presenting with thromboembolism including ischemic cerebral stroke. It is mostly associated with advanced malignancy and characterized by the presence of sterile vegetation on heart valves. The diagnosis is usually based on vegetations seen on an echocardiogram, with negative blood cultures suggesting a noninfectious etiology. The treatment for this condition includes systemic anticoagulation. In this report, we discuss the case of a 61-year-old Caucasian female who presented to our facility with an ischemic stroke. She was found to have vegetations on the mitral valve with negative blood cultures. Further studies revealed metastatic pancreatic cancer. The patient's condition improved following in-hospital management, and she was discharged home for outpatient follow-up and treatment. Through this report, we highlight the importance of considering a search for malignancy in patients presenting with these clinical features. Early diagnosis and prompt management are critical to reduce the complications of NBTE and improve the patients' quality of life.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Cancer-Related Non-Bacterial Thrombotic Endocarditis Presenting as Acute Ischemic Stroke

Savarapu¹,

Abdelazeem²,

Isa³

et al. 2021

Cureus

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“…In addition, nonbacterial thrombotic endocarditis (NBTE) in LC patients had been found led to cerebral hemorrhage in previous researches. [31,32] Radiotherapy and chemotherapy in previous researches, such as whole brain irradiation and several agents including gefitinib, bevacizumab, and sunitinib might aggravate coagulation dysfunctions and lead to cerebral hemorrhage in patients with LC. [33–35] Although such causes leading cerebral hemorrhage mentioned above were not found in present study, they deserved the attention from clinicians.…”

Section: Discussionmentioning

confidence: 99%

The biomarkers and potential pathogenesis of lung cancer related cerebral hemorrhage

et al. 2019

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Cerebral hemorrhage is one of the common complications in patients with lung cancer (LC). Although cancer related cerebral hemorrhage was aware, the pathogenesis and biomarkers of lung cancer related cerebral hemorrhage (LCRCH) remained not well known. The aim of this study was to investigate the pathogenesis and plasma biomarkers of LCRCH. A retrospective review was conducted on acute cerebral hemorrhage patients with active LC who was admitted to the hospital between January 2007 and December 2017. A total of 56 patients with LCRCH (active LC patients with acute cerebral hemorrhage but without conventional vascular risks) was recruited. Meanwhile, 112 patients with active LC alone and gender, age, and subtype of cancer cell matched were recruited as control group. In LCRCH patients, most of the hemorrhagic lesions were located in lobes. And most of them with adenocarcinoma were in medium to terminal stage with poor prognosis short-term. Moreover, LCRCH patients had a lengthened prothrombin time (PT), elevated plasma carcinoembryonic antigen (CEA), cancer antigen 125 (CA125) and cancer antigen 199 (CA199) levels and decreased platelet (PLT) level than did the patients with LC. Multivariate logistic regression analysis showed that lengthened PT, elevated plasm CEA, and CA199 levels were independent risk factors for LCRCH. It was suggested that lengthened PT, elevated plasm CEA and CA199 levels associated with the pathogenesis of LCRCH, and that the Index derived from independent risks should be serve as a specific biomarker of LCRCH.

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“…The exact prevalence of NBTE in cancer patients remains unknown, with the majority of the literature being case studies [ 42 , 69 , 70 , 71 , 72 ]. Sterile, thrombotic vegetations of platelets and fibrin can also deposit on cardiac valves (predominantly mitral and aortic), leading to arterial emboli, which may result in stroke [ 73 ].…”

Section: Pathophysiological Mechanisms Underlying Stroke In Cancermentioning

confidence: 99%

When Two Maladies Meet: Disease Burden and Pathophysiology of Stroke in Cancer

Sun

Bhaskar

2022

IJMS

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Stroke and cancer are disabling diseases with an enormous global burden, disproportionately affecting vulnerable populations and low- and middle-income countries. Both these diseases share common risk factors, which warrant concerted attention toward reshaping population health approaches and the conducting of fundamental studies. In this article, an overview of epidemiological trends in the prevalence and burden of cancer and stroke, underlying biological mechanisms and clinical risk factors, and various tools available for risk prediction and prognosis are provided. Finally, future recommendations for research and existing gaps in our understanding of pathophysiology. Further research must investigate the causes that predispose patients to an increased risk of stroke and/or cancer, as well as biomarkers that can be used to predict growing morbidity and mortality.

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Nonbacterial thrombotic endocarditis presenting as intracerebral hemorrhage

Cited by 13 publications

References 15 publications

Cancer-Related Non-Bacterial Thrombotic Endocarditis Presenting as Acute Ischemic Stroke

Cancer-Related Non-Bacterial Thrombotic Endocarditis Presenting as Acute Ischemic Stroke

The biomarkers and potential pathogenesis of lung cancer related cerebral hemorrhage

When Two Maladies Meet: Disease Burden and Pathophysiology of Stroke in Cancer

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