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performed comprehensively and completely; "an exhaustive study"; "made a thorough search"; "thoroughgoing research" (同)thorough, thoroughgoing

PrepTutorEJDIC

余すところのない,徹底的な
衰弱(荒廃)させる

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2013/09/09 11:49:48」(JST)

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Non-bacterial thrombotic endocarditis (NBTE) is the deposition of small sterile vegetations on 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]

Risk factors[edit source | edit]

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),

lupus and
trauma (e.g., catheters).

Valve predilection[edit source | edit]

The disease affects the valves with the following predilection:

mitral valve > aortic valve > tricuspid valve > pulmonary valve.

Presentation[edit source | edit]

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.

Diagnosis[edit source | edit]

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[edit source | edit]

^ "eMedicine - Neurological Sequelae of Infectious Endocarditis : Article by Milind J Kothari". Retrieved 2008-03-23.
^ "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

UpToDate Contents

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1. 非細菌性血栓性心内膜炎 nonbacterial thrombotic endocarditis
2. 成人における全身性エリテマトーデスの冠動脈疾患以外の心症状 non coronary cardiac manifestations of systemic lupus erythematosus in adults
3. 培養陰性感染性心内膜炎の疫学、微生物学、および診断 epidemiology microbiology and diagnosis of culture negative endocarditis
4. 心臓内および大動脈内の全身性塞栓源の検出における心エコー echocardiography in detection of cardiac and aortic sources of systemic embolism
5. 悪性腫瘍に関連した凝固亢進状態の病因 pathogenesis of the hypercoagulable state associated with malignancy

English Journal

Aerococcus christensenii native aortic valve subacute bacterial endocarditis (SBE) presenting as culture negative endocarditis (CNE) mimicking marantic endocarditis.

Jose A1, Cunha BA2, Klein NC3, Schoch PE4.Author information 1Infectious Disease Division, Winthrop-University Hospital, Mineola, NY, USA.2Infectious Disease Division, Winthrop-University Hospital, Mineola, NY, USA; State University of New York, School of Medicine, Stony Brook, NY, USA. Electronic address: bacunha@winthrop.org.3Infectious Disease Division, Winthrop-University Hospital, Mineola, NY, USA; State University of New York, School of Medicine, Stony Brook, NY, USA.4Microbiology Laboratory, Winthrop-University Hospital, Mineola, NY, USA.AbstractThis is a case report of an adult who presented with apparent culture negative endocarditis (CNE) thought to be marantic endocarditis due to a B-cell lymphoproliferative disorder. This was a most perplexing case and was eventually diagnosed as subacute bacterial endocarditis (SBE) due to a rare slow growing organism. Against the diagnosis of SBE was the lack of fever, hepatomegaly, peripheral manifestations and microscopic hematuria. Also, against a diagnosis of SBE was another explanation for the patient's abnormal findings, e.g., elevated ferritin levels, elevated α1/α2 globulins on SPEP, an elevated alkaline phosphatase, flow cytometry showing B-lymphocytes expressing CD5, and a bone lesion in the right iliac. Findings compatible with both SBE and marantic endocarditis due to a B-cell lymphoproliferative disorder included an elevated ESR, and splenomegaly. Blood cultures eventually became positive during hospitalization. We report a case of native aortic valve (AV) subacute bacterial endocarditis (SBE) due to Aerococcus christensenii mimicking marantic endocarditis due to a B-cell lymphoproliferative disorder. To the best of our knowledge, this is the first reported case of native AV SBE due to A. christensenii presenting as marantic endocarditis.
Heart & lung : the journal of critical care.Heart Lung.2014 Mar-Apr;43(2):161-3. doi: 10.1016/j.hrtlng.2013.11.005. Epub 2013 Nov 23.
This is a case report of an adult who presented with apparent culture negative endocarditis (CNE) thought to be marantic endocarditis due to a B-cell lymphoproliferative disorder. This was a most perplexing case and was eventually diagnosed as subacute bacterial endocarditis (SBE) due to a rare slow
PMID 24341951

A 34 year old man with purple discoloration and paresthesia.

Iranpour A, Mahmoodian R, Haghighi A, Vakili M, Shahriari-Ahmadi A, Hajsadeghi S, Arabi M.Author information Department of Oncology and Rheumatology, Rasool Akram Hospital, Tehran, Iran.AbstractSecondary systemic vasculitis and nonbacterial endocarditis are rare events. We report a case presented with different manifestations of underlying malignancy such as systemic vasculitis, non bacterial endocarditis and DIC (disseminated intravascular coagulopathy). Efforts to find the source of malignancy was unsuccessful and due to patient's unwillingness for further evaluation, finally under the diagnosis of metastatic disease of unknown primary, patient is receiving cyclic chemotherapy.
International journal of hematology-oncology and stem cell research.Int J Hematol Oncol Stem Cell Res.2014;8(1):41-5.
Secondary systemic vasculitis and nonbacterial endocarditis are rare events. We report a case presented with different manifestations of underlying malignancy such as systemic vasculitis, non bacterial endocarditis and DIC (disseminated intravascular coagulopathy). Efforts to find the source of mali
PMID 24505550

[Establishment of a chronic obstructive pulmonary disease model by passive cigarette smoking and intratracheal LPS instillation in spontaneously hypertensive rats].

Yu C1, Chen Y, Li T, Li W, Cai S, Meng Y.Author information 1Department of Respiratory Disease, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China.E-mail: ych4231@gmail.com.AbstractOBJECTIVE: To establish a chronic obstructive pulmonary disease (COPD) model by passive cigarette smoking and (or) intratracheal instillation of lipopolysaccharide (LPS) in spontaneously hypertensive (SH) rats.
Nan fang yi ke da xue xue bao = Journal of Southern Medical University.Nan Fang Yi Ke Da Xue Xue Bao.2013 Sep;33(9):1341-6.
OBJECTIVE: To establish a chronic obstructive pulmonary disease (COPD) model by passive cigarette smoking and (or) intratracheal instillation of lipopolysaccharide (LPS) in spontaneously hypertensive (SH) rats.METHODS: Fifteen male SH rats were randomly divided into control group, cigarette smoking
PMID 24067217