Nonbacterial Thrombotic Endocarditis Associated With Crohn Disease

Area of Science:

• Cardiology
• Gastroenterology
• Pathology

Background:

• Nonbacterial thrombotic endocarditis (NBTE) is a rare condition characterized by sterile vegetations on heart valves.
• Crohn disease is a chronic inflammatory bowel disease with potential systemic manifestations.
• NBTE can present with embolic events, often mimicking infective endocarditis.

Observation:

• An atypical case of NBTE involving the mitral valve is presented.
• The patient experienced recurrent embolic events following remission of acute-phase Crohn disease.
• Echocardiography showed mitral valve thickening, initially raising suspicion for infective endocarditis or cardiac tumors.

Findings:

• Pathologic and laboratory examinations confirmed NBTE.
• The patient tested negative for antiphospholipid syndrome and had no evidence of a malignant tumor.
• This case highlights a rare complication of NBTE in the context of Crohn disease.

Implications:

• This case underscores the importance of considering NBTE in patients with inflammatory conditions like Crohn disease presenting with embolic phenomena.
• Accurate diagnosis is crucial to differentiate NBTE from infective endocarditis or malignancy, guiding appropriate management.
• Further research may elucidate the specific mechanisms linking Crohn disease to NBTE.