The immune sequelae of endocarditis was first suspected when biopsy of Osler nodes - the well-known cutaneous manifestations of IE on the fingers and toes - demonstrated a sterile vasculitis.

IE produces multiple complications, from embolic disease from valvular vegetations such as cerebrovascular accidents and splenic infarcts, to other manifestations that are not clearly secondary to embolism. Historical background of immunologic sequelae Rheumatologists should be aware of the ways IE can mimic systemic autoimmune conditions. A minority of patients may not even develop a fever. Subacute infectious endocarditis can be subtle, presenting over months of progressive, non-specific symptoms. Although IE can look very similar to a small vessel vasculitis, the consequences of immunosuppressing this patient could be devastating. Some clues to the diagnosis may be present, including fever, weight loss, normal platelets (usually high in active vasculitis) and low complements (usually normal in ANCA vasculitis). Although it sounds like ANCA vasculitis, this is actually a great example of a patient with subacute infectious endocarditis (IE). We do not endorse non-Cleveland Clinic products or services PolicyĪ patient presents to the hospital with a 6-week history of malaise, oligoarticular asymmetric inflammatory arthritis, palpable purpura on lower extremities, acute kidney injury and the presence of red blood cell casts on urine microscopy. Advertising on our site helps support our mission. Cleveland Clinic is a non-profit academic medical center.

Autoimmune phenomena symptoms