Case Report: Marantic Endocarditis in Renal Cell Carcinoma: Nephrectomy a Treatment

Background Marantic endocarditis (non-bacterial thrombotic endocarditis) is a rare condition that involves non-infectious thrombotic lesions typically of the aortic and mitral valves. It is predominantly associated with malignancy and less-commonly systemic lupus erythematosus. In this case, we report a patient with marantic endocarditis secondary to a renal cell carcinoma that was successfully treated with nephrectomy and anticoagulation. Case Summary A 65-year-old male patient with embolic signs and symptoms was found to have non-infective thrombotic vegetations on three cardiac valves through transoesophageal echocardiography. Computed tomography (CT) revealed a 70 mm renal mass that confirmed to be a grade two clear-cell renal cell carcinoma. Nephrectomy and anti-coagulation led to resolution of the embolic symptoms and of the valvular vegetations. Discussion The diagnosis of marantic endocarditis requires high clinical suspicion in a patient who presents with features of embolisation. Incidence is highest in patients with an underlying malignancy, particularly adenocarcinoma. This case highlights the importance of echocardiography in diagnosis, removal of the source of thrombus, and prompt treatment with anti-coagulation.

Marantic Endocarditis Associated with COVID-19: A Rare Case Report of a Potentially Deadly Disease

Coronavirus disease 2019 (COVID-19) has overwhelmed healthcare globally with millions of cases and over 2 million deaths worldwide. The hypercoagulable state associated with COVID-19 is a well-recognized complication that carries a poor prognosis. Marantic endocarditis, or non-bacterial thrombotic endocarditis (NBTE), is caused by a sterile vegetation on the cardiac valves resulting from the deposition of fibrin and platelet aggregates. It is highly associated with the hypercoagulable and acquired inflammatory states. Herein, we report a unique and rare case of COVID-19 presenting with NBTE.

Nonbacterial thrombotic endocarditis as a cause of systemic embolism

We presented a clinical case of the non-bacterial thrombotic endocarditis in a patient with ischemic stroke of embolic origin. Imaging methods (transthoracic and transesophageal echocardiography) showed specific features of thrombotic vegetations on mitral and aortic heart valves. Laboratory work-up (blood culture, serological examination) excluded infective endocarditis as a cause of vegetations. Diagnostic work-up with computed tomography showed lung tumor with metastatic foci in bones. Presented case demonstrates need for awareness regarding nonbacterial thrombotic endocarditis in patients with systemic embolism and in specific groups of patients (autoimmune diseases and oncology). Key words: nonbacterial thrombotic endocarditis, marantic endocarditis, echocardiography, systemic embolism.