Acquired aortic stenosis in systemic lupus erythematosus

Area of Science:

• Cardiology
• Rheumatology
• Pathology

Background:

• Systemic lupus erythematosus (SLE) is a chronic autoimmune disease with diverse clinical manifestations.
• Cardiac involvement in SLE can range from pericarditis to myocarditis and valvular disease.
• Thrombotic events are a known complication of SLE, particularly in patients with antiphospholipid antibodies.

Observation:

• Two patients with SLE presented with severe aortic valvular stenosis.
• The stenosis was attributed to extensive thrombotic deposits on the aortic valve leaflets.
• A similar mechanism causing mitral stenosis in an SLE patient has been previously reported.

Findings:

• Massive thrombotic deposits on the aortic valve represent a novel cause of aortic valvular stenosis in SLE.
• This finding expands the spectrum of cardiac valvular pathology associated with SLE.
• The thrombotic etiology suggests a link to the prothrombotic state often seen in SLE.

Implications:

• Recognition of this rare complication is crucial for timely diagnosis and management of SLE patients with cardiac symptoms.
• Further research is warranted to elucidate the specific mechanisms underlying valvular thrombosis in SLE.
• This could lead to improved monitoring and therapeutic strategies for cardiovascular complications in SLE.