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Bacterial endocarditis complicating systemic lupus erythematosus.

T J Lehman, S T Palmeri, C Hastings

    The Journal of Rheumatology
    |August 1, 1983
    PubMed
    Summary

    Bacterial endocarditis is more common in patients with systemic lupus erythematosus (SLE) than in other connective tissue diseases. This study found a higher frequency of bacterial endocarditis in SLE patients at the National Institutes of Health (NIH).

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    Area of Science:

    • Rheumatology
    • Infectious Diseases
    • Cardiology

    Background:

    • Systemic lupus erythematosus (SLE) is an autoimmune disease affecting multiple organs.
    • Bacterial endocarditis is a serious infection of the heart valves.
    • The frequency of bacterial endocarditis in SLE patients is not well-established.

    Purpose of the Study:

    • To determine the frequency of bacterial endocarditis in patients with SLE.
    • To compare the frequency of bacterial endocarditis in SLE patients to other connective tissue disease patients.

    Main Methods:

    • Retrospective review of patients admitted to the National Institutes of Health (NIH).
    • Analysis of medical records for diagnosis of bacterial endocarditis and SLE.
    • Echocardiography was performed on a subset of SLE patients.

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    Main Results:

    • Six out of 571 SLE patients developed culture-proven bacterial endocarditis.
    • Only one patient had a pre-existing valvular abnormality.
    • Bacterial endocarditis occurred in 2 patients following dental procedures; no precipitating event was identified in the other 4.
    • Echocardiography did not reveal previously unrecognized cardiac disease in 20 SLE patients.
    • The frequency of bacterial endocarditis was unexpectedly high in SLE patients compared to other connective tissue disease patients.

    Conclusions:

    • Patients with SLE have a higher risk of developing bacterial endocarditis.
    • Cardiac evaluation in SLE patients should consider the risk of bacterial endocarditis, even in the absence of known valvular disease.
    • Further research is needed to understand the mechanisms underlying this increased risk.