Nonbacterial Thrombotic Endocarditis Complicated by Cerebral Infarction in a Patient with Adenomyosis with High Serum CA125 Level; A Case Report

Kenji Uchino, Uchino K, Takahiro Shimizu, Shimizu T, Mizukami H, Heisuke Mizukami, Kenji Isahaya, Isahaya K, Hana Ogura, Ogura H, Shinohara K, Kensuke Shinohara, Hasegawa Y, Yasuhiro Hasegawa
Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association · 2017 · vol. 27(3) , pp. e42–e45 · doi:10.1016/j.jstrokecerebrovasdis.2017.09.064 · PMID:29102541 · W2765090422
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A case report details a patient with adenomyosis and elevated serum CA125 who developed nonbacterial thrombotic endocarditis complicated by cerebral infarction.

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Abstract

We report a case of a 48-year-old woman with multiple cerebral infarctions caused by nonbacterial thrombotic endocarditis (NBTE) because of adenomyosis with high serum carbohydrate antigen (CA)125 level. Transesophageal echocardiography (TEE) showed a vegetation, 4 mm in diameter, adjacent to the anterior leaflet of the mitral valve on day 2. Soluble CA125 level was elevated to 901 U/mL. Intravenous infusion of unfractionated heparin sodium was started. On day 35, TEE revealed reduction of the vegetation in size, 2 mm in diameter. On day 38, she was transferred to the hospital for further rehabilitation. CA125 is a transmembrane mucin that contributes to the progression of epithelial ovarian cancer. It is important to keep in mind that adenomyosis with abnormally high serum CA125 level may be at high risk of NBTE.

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Condition tags

adenomyosis

MeSH descriptors

Adenomyosis CA-125 Antigen Cerebral Infarction Endocarditis, Non-Infective Membrane Proteins Thrombosis Adenomyosis Adenomyosis Adenomyosis Anticoagulants Anticoagulants CA-125 Antigen Cerebral Angiography Cerebral Angiography Cerebral Infarction Cerebral Infarction Diffusion Magnetic Resonance Imaging Echocardiography, Transesophageal Endocarditis, Non-Infective Endocarditis, Non-Infective

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