A 28-year-old woman with systemic lupus erythematosus presents with progressive fatigue and exertional dyspnea. Vital signs: BP 118/76 mmHg, HR 92 bpm, RR 18, Temp 37.2°C, SpO2 98% on room air. She denies fever and recent infections. Echocardiography demonstrates small, sterile vegetations on both mitral valve leaflets. Blood cultures remain negative after 48 hours. Rheumatoid factor is elevated. Which diagnosis best explains these findings?
- A)Acute infective endocarditis
- B)Nonbacterial thrombotic endocarditis
- C)Myxomatous degeneration
- D)Libman Sacks endocarditisGABARITO
- E)Rheumatic valvulitis
Explicação
Libman Sacks endocarditis is correct. Systemic lupus erythematosus can cause sterile vegetations on either or both sides of valve leaflets due to immune mediated valvular injury. Negative blood cultures and the autoimmune background argue strongly against infe... Ver explicação completa e trilha adaptativa →