Nonbacterial thrombotic endocarditis: Difference between revisions
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'''Non-bacterial thrombotic endocarditis''' (NBTE) is a form of [[endocarditis]] in which small [[sterility (physiology)|sterile]] [[vegetation (pathology)|vegetation]]s are deposited on the [[heart valve|valve]] leaflets. Formerly known as '''marantic endocarditis''', which comes from the [[Greek language|Greek]] ''marantikos'', meaning “wasting away.”<ref>{{EMedicine|article|1165712|Neurological Sequelae of Infectious Endocarditis}}</ref> the term "marantic endocarditis" is still sometimes used to emphasize the association with a wasting state<ref>{{cite web |url=http://www.merck.com/mmpe/sec07/ch077/ch077c.html#sec07-ch077-ch077b-1476 |title=Noninfective Endocarditis: Endocarditis: Merck Manual Professional |format= |work= |accessdate=2008-12-22}}</ref> such as [[cancer]].<ref>{{cite web |url=http://cancerweb.ncl.ac.uk/cgi-bin/omd?marantic+endocarditis |title=Definition: marantic endocarditis from Online Medical Dictionary |format= |work= |accessdate=2008-12-22}}</ref> |
'''Non-bacterial thrombotic endocarditis''' ('''NBTE''') is a form of [[endocarditis]] in which small [[sterility (physiology)|sterile]] [[vegetation (pathology)|vegetation]]s are deposited on the [[heart valve|valve]] leaflets. Formerly known as '''marantic endocarditis''', which comes from the [[Greek language|Greek]] ''marantikos'', meaning “wasting away.”<ref>{{EMedicine|article|1165712|Neurological Sequelae of Infectious Endocarditis}}</ref> the term "marantic endocarditis" is still sometimes used to emphasize the association with a wasting state<ref>{{cite web |url=http://www.merck.com/mmpe/sec07/ch077/ch077c.html#sec07-ch077-ch077b-1476 |title=Noninfective Endocarditis: Endocarditis: Merck Manual Professional |format= |work= |accessdate=2008-12-22}}</ref> such as [[cancer]].<ref>{{cite web |url=http://cancerweb.ncl.ac.uk/cgi-bin/omd?marantic+endocarditis |title=Definition: marantic endocarditis from Online Medical Dictionary |format= |work= |accessdate=2008-12-22}}</ref> |
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==Histopathology== |
==Histopathology== |
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Revision as of 08:32, 26 December 2016
| Nonbacterial thrombotic endocarditis | |
|---|---|
| Specialty | Cardiology  |
Non-bacterial thrombotic endocarditis (NBTE) is a form of endocarditis in which small sterile vegetations are deposited on the valve leaflets. Formerly known as marantic endocarditis, which comes from the Greek marantikos, meaning “wasting away.”[1] the term "marantic endocarditis" is still sometimes used to emphasize the association with a wasting state[2] such as cancer.[3]
Histopathology
Grossly, vegetations form along lines of valve closure and are generally symmetric with a smooth or verrucoid (warty) texture. Histologically, lesions are composed of fibrin[4] (eosinophilic) and platelets but, unlike bacterial etiologies, contain little evidence of PMNs, microorganisms or inflammation.
Risk factors
Marantic vegetations are often associated with previous rheumatic fever.
Other risk factors include:
- hypercoagulable states
- malignant cancers, especially mucin-producing adenocarcinomas (most commonly associated with pancreatic adenocarcinomas)
- systemic lupus erythematosus: Referred to as Libman-Sacks endocarditis
- trauma (e.g., catheters)
Valve predilection
The disease affects the valves with the following predilection: aortic valve > mitral valve > tricuspid valve > pulmonary valve [5]
Diagnosis
Due to the non-invasive nature of NBTE, clinical examination may or may not reveal a new murmur.
An embolic stroke may be the first feature to suggest the diagnosis of NBTE. An echocardiograph may be used to further assess for valvular lesions.
References
- ^ Neurological Sequelae of Infectious Endocarditis at eMedicine
- ^ "Noninfective Endocarditis: Endocarditis: Merck Manual Professional". Retrieved 2008-12-22.
- ^ "Definition: marantic endocarditis from Online Medical Dictionary". Retrieved 2008-12-22.
- ^ "nonbacterial thrombotic endocarditis" at Dorland's Medical Dictionary
- ^ Eiken PW, Edwards WD, Tazelaar HD, McBane RD, Zehr KJ (2001). "Surgical pathology of nonbacterial thrombotic endocarditis in 30 patients, 1985–2000". Mayo Clin. Proc. 76 (12): 1204–12. doi:10.4065/76.12.1204. PMID 11761501.