Libman-Sacks endocarditis is a form of nonbacterial endocarditis that is seen in systemic lupus erythematosus. It is the most common cardiac manifestation of lupus.

It was first described by Drs. Emanuel Libman and Benjamin Sacks at Mount Sinai Hospital in New York City in 1924. The association between Libman-Sacks endocarditis and Antiphospholipid syndrome was first noted in 1985.

Presentation

The vegetations are small and formed from strands of fibrin, neutrophils, lymphocytes, and histiocytes. The mitral valve is typically affected, and the vegetations occur on the ventricular and atrial surface of the valve. Libman-Sacks lesions rarely produce significant valve dysfunction and the lesions only rarely embolize.

Pathology

The pathology is the same as nonbacterial thrombotic endocarditis except focal necrosis (hematoxylin bodies) can be found only in Libman-Sacks endocarditis.

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