Intracardiac thrombosis and mitral prosthesis dysfunction in systemic lupus erythematosus. A case report

Systemic lupus erythematosus (SLE) is an inflammatory disease characterized by deposition of autoantibodies and pathogenic immune complexes in the cells and tissues of an organism, causing lesions. The heart is one of the most frequently involved organs, valvar involvement being common (27%) and of great clinical importance. Some studies suggest that valvar involvement is associated with the presence of a specific autoantibody, the antiphospholipid antibody (aPL). In these circumstances, major complications may occur such as arterial or venous thrombosis, thrombocytopenia, repeated spontaneous abortions and presence of lupus anticoagulant antibody. Among the semiologic methods for cardiac evaluation, echocardiography is the main instrument for investigating the anatomical and functional involvement of the heart in the great majority of systemic diseases like SLE. We report the case of a patient with SLE and aPL syndrome who underwent surgery for mitral valve replacement with a biological prosthesis and died nine months later due to massive intracardiac thrombosis and prosthesis dysfunction.