Case report: Successful non-surgical management of massive isolated tricuspid Libman-Sacks endocarditis in a pregnant patient with SLE and secondary APS - Scorecard - MDSpire

Case report: Successful non-surgical management of massive isolated tricuspid Libman-Sacks endocarditis in a pregnant patient with SLE and secondary APS

  • By

  • Duan, Jiaoniu

  • Han, Lin

  • Zhao, Wenli

  • Zhang, Gailian

  • May 18, 2026

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Clinical Scorecard: Case Study: Effective Non-Invasive Treatment of Extensive Isolated Tricuspid Libman-Sacks Endocarditis in a Pregnant Woman with SLE and Secondary APS

At a Glance

CategoryDetail
ConditionIsolated tricuspid valve Libman-Sacks endocarditis
Key MechanismsSevere thrombocytopenia, systemic lupus erythematosus, secondary antiphospholipid syndrome
Target PopulationPregnant women with SLE and secondary APS
Care SettingMedical management in a clinical setting

Key Highlights

  • Rare occurrence of isolated tricuspid valve Libman-Sacks endocarditis during pregnancy
  • Patient declined surgery and opted for medical management
  • Intensive immunomodulatory therapy led to favorable outcomes
  • Near-complete regression of vegetations observed at nine months
  • Successful delivery of a healthy infant

Guideline-Based Recommendations

Diagnosis

  • Echocardiography to identify vegetations

Management

  • Pulse methylprednisolone, plasma exchange, intravenous immunoglobulin, cyclosporine, hydroxychloroquine, and anticoagulation

Monitoring & Follow-up

  • Platelet count and echocardiographic assessment of vegetations

Risks

  • Severe thrombocytopenia and potential for cardiac surgery

Patient & Prescribing Data

Pregnant women with SLE and secondary APS

Anticoagulation initiated after partial platelet recovery

Clinical Best Practices

  • Consider non-surgical management options in pregnant patients with severe conditions
  • Monitor platelet levels closely during treatment
  • Utilize a combination of immunomodulatory therapies for effective management

Related Resources & Content

    Original Source(s)

    Case report: Successful non-surgical management of massive isolated tricuspid Libman-Sacks endocarditis in a pregnant patient with SLE and secondary APS

    • by Duan, Jiaoniu , Han, Lin , Zhao, Wenli , Zhang, Gailian

    • May 18, 2026

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