Libman-Sacks endocarditis is a non-infective endocarditis characteristically seen in systemic lupus erythematosus. The vegetations in Libman-Sacks endocarditis are pathologically distinguished from acute rheumatic fever (Aschoff body-associated) endocarditis by:

• A Involvement of only the mitral valve, never other valves
• B Large irregular vegetations predominantly on the ventricular surface at the line of closure
• C Granulomatous Aschoff nodules within the valve stroma
• D Small, sterile vegetations on BOTH surfaces (atrial and ventricular) of the mitral valve leaflet ✓

Explanation

Libman-Sacks (verrucous) endocarditis of SLE characteristically produces small, sterile, flat vegetations on both surfaces of the mitral (and occasionally tricuspid) valve — including the ventricular surface and even the chordae — distinguishing it from acute rheumatic endocarditis which has small 1–2 mm vegetations only along the line of closure on the atrial surface (warty vegetations). Aschoff nodules are the histological hallmark of rheumatic carditis, not Libman-Sacks.

Reference: Robbins & Cotran Pathologic Basis of Disease, 10th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.