[Cerebral embolism in systemic lupus erythematosus with Libman-Sacks endocarditis: a case report]

We presented a patient of cerebral embolism caused by Libman-Sacks endocarditis with systemic lupus erythematosus (SLE). This 35-year-old housewife with SLE suffered from abrupt visual disturbance in December 1998. Angiography revealed the occlusion of her right posterior cerebral artery. Transesophageal echocardiography showed the mitral regurgitation and hyperplasia of the anterior mitral valve leaflet without vegetation. In April 1999, she again suffered from sudden onset of transient left hemiparesis and dysphasia. Angiographic findings were unchanged. Transesophageal echocardiographic examination detected vegetation on the anterior mitral valve leaflet and aggravation of the mitral regurgitation. Laboratory examination revealed inactivity of SLE. No bacteria was recovered from repeated blood cultures. We diagnosed that Libman-Sacks vegetation caused cerebral embolism.