Valvular dysfunction in antiphospholipid syndrome: Prevalence, clinical features, and treatment

Valvular abnormalities develop in 36% and 35% of patients with primary antiphospholipid syndrome (PAPS) and with systemic lupus erythematosus (SLE) respectively, and in 48% of patients with SLE and antiphospholipid antibodies (aPL). Valvulopathy includes leaflet thickening, vegetations, regurgitatio...

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Bibliographic Details
Published in:Seminars in arthritis and rheumatism 1997-08, Vol.27 (1), p.27-35
Main Authors: Nesher, Gideon, Ilany, Jacob, Rosenmann, David, Abraham, Abraham S.
Format: Article
Language:English
Subjects:
Adrenal Cortex Hormones - administration & dosage
Adult
Antiphospholipid Syndrome - complications
Antiphospholipid Syndrome - epidemiology
Biological and medical sciences
Female
Heart Valve Diseases - drug therapy
Heart Valve Diseases - epidemiology
Heart Valve Diseases - etiology
Humans
Lupus Erythematosus, Systemic - complications
Lupus Erythematosus, Systemic - epidemiology
Medical sciences
Middle Aged
Prevalence
Risk Factors
Sarcoidosis. Granulomatous diseases of unproved etiology. Connective tissue diseases. Elastic tissue diseases. Vasculitis
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Summary:Valvular abnormalities develop in 36% and 35% of patients with primary antiphospholipid syndrome (PAPS) and with systemic lupus erythematosus (SLE) respectively, and in 48% of patients with SLE and antiphospholipid antibodies (aPL). Valvulopathy includes leaflet thickening, vegetations, regurgitation, and stenosis. A literature survey shows that significant morbidity from valvular dysfunction, mostly mitral regurgitation leading to congestive heart failure, occurs in 4% and 6% of SLE and PAPS patients, respectively. The pathogenesis of valvulopathy may involve interaction of aft with antigens on the valve surface, resulting in valvulitis. Current therapy includes symptomatic measures and valve replacement. A novel approach for symptomatic antiphospholipid syndrome (APS) related valvulopathy involves treatment with systemic corticosteroids. We describe four such patients and their dramatic clinical and hemodynamic response to treatment with prednisone when symptomatic measures failed.
ISSN:0049-0172
1532-866X
DOI:10.1016/S0049-0172(97)80034-0