Antiphospholipid antibody syndrome secondary to SLE complicated with Libman-Sacks endocarditis: a case report

In clinical practice, partial patients with systemic lupus erythematosu （SLE） can develop secondary antiphospholipid antibody syndrome （APS）, whereas simultaneous complication with non-bacterial endocarditis is rarely encountered. In this article, the diagnosis and treatment of one case of APS secondary to SLE complicated with Libman-Sacks endocarditis were reported. Prior to admission, the patient presented with fever, joint pain, sore throat and rash. UCG upon admission revealed the mass in the anterior leaflet of mitral valve. The patient was tested positive for lupus antibody, antiphospholipid antibody and lupus-like anticoagulant test. The symptoms were not alleviated after anti-infection therapy. Subsequently, the patient suffered from dizziness, numbness around the mouth, unclear articulation and dysphagia. Cranial MRI revealed a new medullary infarction lesion. Combined with clinical manifestations, physical signs and auxiliary examinations, the patient was diagnosed with APS, Libman-Sacks endocarditis, medullary infarction and SLE. After immunosuppression, immunomodulation and low-molecule heparin anticoagulation interventions, the patient was improved and discharged from hospital. The diagnosis and treatment of this case prompted that besides IE, the possibility of APS secondary to SLE should also be considered when UCG revealed a neoplasm, especially for young women who had no clear history of valvular heart diseases. Early diagnosis of APS complicated with Libman-Sacks endocarditis and individualized anticoagulation therapy can yield favorable clinical efficacy.