Embolic stroke complicating systemic lupus erythematosus
P. B. Gorelick, M. S. Rusinowitz, M. Tiku, L. W. McDonald and L. Robbins
Embolic stroke complicating systemic lupus erythematosus has been
infrequently reported. We examined a 25-year-old woman who suddenly became
hemiplegic. Two-dimensional echocardiography identified a source of emboli.
At cardiac surgery, friable thrombotic vegetations were found adhering to
the mitral valve leaflets, left ventricular septal wall, and chordae
tendineae. At autopsy several weeks later, careful pathologic examination
of the heart failed to reveal evidence of thrombus formation or
endocarditis. An embolus identical in appearance to the thrombotic
vegetations described at cardiac surgery was found lodged in the left
middle cerebral artery underlying the recent brain infarction. To our
knowledge, this is the first report of embolic stroke in systemic lupus
erythematosus caused by extensive cardiac thrombus formation in the absence
of underlying endocarditis.
