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Medline ® Abstracts for References 1-6

of 'Nonbacterial thrombotic endocarditis'

1
TI
Non-bacterial thrombotic endocarditis: clinicopathologic correlations.
AU
Deppisch LM, Fayemi AO
SO
Am Heart J. 1976;92(6):723.
 
Sixty-five cases of nonbacterial thrombotic endocarditis (NBTE) were discovered at autopsy during a 10 year period--an incidence of 1.6 per cent in the adult autopsy population. In 51 cases, one or more malignant neoplasms were associated; adenocarcinoma represented the most frequent histologic type of related neoplasm. Coagulation abnormalities suggestive of disseminated intravascular coagulation (DIC) were present in 18.5 per cent of the cases. It is possible that both the valvular and peripheral intravascular thromboses in at least some cases of NBTE represent the abnormal coagulation of DIC. Arterial thrombosis with infarction occurred in many peripheral organs. Splenic and renal were most frequent, but cerebral and cardiac consequences were the most significant.
AD
PMID
2
TI
Nonbacterial thrombotic endocarditis in patients with malignant neoplastic diseases.
AU
Rosen P, Armstrong D
SO
Am J Med. 1973;54(1):23.
 
AD
PMID
3
TI
Non-bacterial thrombotic endocarditis in cancer patients.
AU
González Quintela A, Candela MJ, Vidal C, Román J, Aramburo P
SO
Acta Cardiol. 1991;46(1):1.
 
A total of 10 cases of non-bacterial thrombotic endocarditis (NBTE) were found among 1640 adult patients, autopsied in a 24-year period. Eight out of 10 patients had an underlying malignant tumor, NBTE was more common in cancer patients than in patients without malignancy (1.25% vs 0.2%, P less than 0.05). Patients with adenocarcinoma were at higher risk than patients with other malignant processes (2.70% vs 0.47%, P less than 0.05); especially in cases of pancreatic cancer in comparison with other kinds of adenocarcinoma (10.34% vs 1.55%, P less than 0.05). Systemic embolization was the main cause of morbidity. Any thromboembolic event in cancer patients should prompt a search for NBTE. NBTE may be present in undisseminated cancers in otherwise curable patients.
AD
Department of Medicine, Clinica Puerta de Hierro.
PMID
4
TI
[Nonbacterial thrombotic endocarditis--a study of 171 case reports].
AU
Steiner I
SO
Cesk Patol. 1993;29(2):58.
 
A descriptive term nonbacterial thrombotic endocarditis (NBTE) is used currently instead of the former name marantic endocarditis. The study describes 171 cases of NBTE encountered in autopsies over a period of 22 years (an incidence of 0.93% in adults). Malignancy was present in 59% of cases. Tumors relatively most frequently associated with NBTE were carcinomas of the ovaries, biliary system, pancreas, lung, and stomach. The vegetations were located mostly on the left-sided valves (mitral 64%, aortic 24%, both 9%). The involved valves were otherwise normal in 82%, and they were previously damaged in 18%. Systemic emboli from valvular vegetations occurred in 41% of patients, with splenic, cerebral, and renal circulations being most frequently affected. Pulmonary embolism was noted in 43%. The state of nutrition at autopsy was within normal limits in 35%; there was undernourishment or cachexia in 40%, and overweight or obesity in 22% of patients. The main pathogenetic factor in NBTE seems to be a state of hypercoagulation.
AD
Fingerlandůvústav patologie LF UK, Hradec Králové.
PMID
5
TI
[Nonbacterial thrombotic endocarditis: clinicopathologic study of a necropsy series].
AU
Llenas-García J, Guerra-Vales JM, Montes-Moreno S, López-Ríos F, Castelbón-Fernández FJ, Chimeno-García J
SO
Rev Esp Cardiol. 2007 May;60(5):493-500.
 
INTRODUCTION AND OBJECTIVES: Nonbacterial thrombotic endocarditis (NBTE) is characterized by sterile platelet and fibrin deposition on cardiac valves. In this study, our aim was to investigate the clinicopathologic characteristics of patients diagnosed with NBTE at the 12 de Octubre University Hospital in Madrid, Spain.
METHODS: Patients were identified by analyzing reports of autopsies carried out at the Anatomical Pathology Department of the University Hospital between 1974 and 1977 and between 1980 and 2004.
RESULTS: Out of 2041 autopsies, 22 (1.08%) showed evidence of NBTE. The patients' average age was 63.04 years, and neither sex predominated. The underlying disease was an infection in 54.5% of cases, whereas 31.8% had a neoplasm, most frequently a pancreatic adenocarcinoma or renal carcinoma. In 10 cases, there was a previous valvulopathy. The mitral valve was most frequently affected by NBTE (36.5% of cases). In most cases, the cause of death was the underlying disease, though in two patients it was directly related to NBTE (9.1%). In nine cases, an embolism occurred, principally in the spleen, the kidneys or the central nervous system. Before death, there was no suspicion of NBTE in any of these cases.
CONCLUSIONS: NBTE is an uncommon disease entity that occurs not only in patients with end-stage neoplastic disease, but also in those with potentially treatable diseases. Consequently, we should raise our level of awareness of this condition so that a diagnosis can be made before the patient dies and anticoagulant treatment can be started, thereby helping to improve prognosis.
AD
Servicio de Medicina Interna, Hospital Universitario 12 de Octubre, Madrid, Spain. jarallenas@hotmail.com
PMID
6
TI
Surgical pathology of nonbacterial thrombotic endocarditis in 30 patients, 1985-2000.
AU
Eiken PW, Edwards WD, Tazelaar HD, McBane RD, Zehr KJ
SO
Mayo Clin Proc. 2001 Dec;76(12):1204-12.
 
OBJECTIVE: To describe the causes, complications, and histological appearance of nonbacterial thrombotic endocarditis (NBTE) in a surgical population compared with those in previously reported autopsy series.
PATIENTS AND METHODS: Cases were identified by reviewing the surgical pathology reports for all cardiac valvular specimens removed at Mayo Clinic, Rochester, Minn., between 1985 and 2000. Archived microscopic slides and medical records were reviewed for each study patient.
RESULTS: The study group consisted of 30 patients (20 female and 10 male), with a mean age of 49 years (range, 15-89 years). Of these 30 patients, 28 had single valve involvement (19 mitral, 8 aortic, and 1 tricuspid), and 2 had involvement of both their mitral and aortic valves. An underlying immune-mediated disorder was identified in 18 patients (60%), including primary antiphospholipid syndrome (in 8), rheumatic heart disease (in 6), systemic lupus erythematosus (in 2), and rheumatoid arthritis (in 2), 15 (83%) of whom were women. Of the remaining 12 patients with no autoimmune disease, only 5 (42%) were women. No patient had metastatic malignant disease or disseminated intravascular coagulopathy. Systemic embolization was documented in 10 patients (33%), 8 of whom had cerebral involvement. Valvular vegetations were visualized by echocardiography before surgery in 8 patients and were suspected but not confirmed preoperatively in 1 patient. All vegetations consisted primarily of platelets and fibrin. The site and appearance of vegetations did not vary with the underlying disease state.
CONCLUSIONS: In contrast to previously reported autopsy series, NBTE in a surgical population was more commonly associated with autoimmune disorders than malignancy or disseminated intravascular coagulopathy. Women were affected twice as often as men. Systemic embolization, particularly to the brain, was prominent in both surgical and autopsy series. Vegetations had a similar appearance regardless of the specific underlying disease. An antemortem diagnosis of NBTE in a patient with no known risk factors should prompt a search not only for occult malignancy, as suggested by autopsy studies, but also for autoimmune or rheumatic diseases, particularly the antiphospholipid syndrome.
AD
Mayo Medical School, Division of Anatomic Pathology, Mayo Clinic, Rochester, Minn. 55905, USA.
PMID