Libman-Sacks endocarditis as the first manifestation of systemic lupus erythematosus in an adolescent, with a review of the literature

Libman-Sacks endocarditis is rare in children and adolescents, more so as a first manifestation of systemic lupus erythematosus. Currently, sterile verrucous lesions of Libman-Sacks endocarditis are recognised as a cardiac manifestation of both systemic lupus erythematosus and antiphospholipid syndrome. They are clinically silent in a majority of the cases. The presence of antiphospholipid antibodies in systemic lupus erythematosus is associated with three times higher prevalence of mitral valve nodules and significant mitral regurgitation. We present the case of isolated mitral regurgitation with abnormal looking mitral valve, detected in early childhood, which deteriorated to a severe degree in the next decade and was diagnosed as Libman-Sacks endocarditis after surgical repair from histopathology. The full-blown clinical spectrum of systemic lupus erythematosus with antiphospholipid antibodies was observed several weeks after cardiac surgery. We discuss the atypical course of Libman-Sacks endocarditis with follow-up for 10 years, along with a review of the literature

Dengue fever as a cause of perimyocarditis and low-pressure cardiac tamponade

© 2018, Copyright © 2018 Baylor University Medical Center. We describe a case of dengue shock syndrome, perimyocarditis, and low-pressure cardiac tamponade following a trip to the Caribbean. The case was managed in the critical care unit and 6 weeks after discharge the patient was asymptomatic with a normal ejection fraction. Dengue fever presenting as cardiac tamponade is exceedingly rare and emphasizes the importance of taking a thorough travel history as well as being aware of atypical manifestations of rare diseases to make a correct diagnosis

Relaxation and curvature-induced molecular flows within multicomponent membranes

The quantitative understanding of membranes is still rooted in work performed in the 1970s by Helfrich and others, concerning amphiphilic bilayers. However, most biological membranes contain a wide variety of nonamphiphilic molecules too. Drawing analogy with the physics of nematic/non-nematic mixtures, we present a dynamical (out of equilibrium) description of such multicomponent membranes. The approach combines nematohydrodynamics in the linear regime and a proper use of (differential) geometry. The main result is to demonstrate that one can obtain equations describing a cross-diffusion effect (similar to the Soret and Dufour effects) between curvature and the (in-membrane) flow of amphiphilic molecules relative to nonamphiphilic ones. Surprisingly, the shape of a membrane relaxes according to a simple heat equation in the mean curvature, a process that is accompanied by a simultaneous boost to the diffusion of amphiphiles away from regions of high curvature. The model also predicts the inverse process, by which the forced bending of a membrane induces a flow of amphiphilic molecules towards areas of high curvature. In principle, numerical values for the relevant diffusion coefficients should be verifiable by experiment.Comment: 10 pages (incl. appendix and references), one figur