Libman-Sacks Endocarditis Differential Diagnoses

Updated: Dec 14, 2020
  • Author: Mary C Rodriguez Ziccardi, MD; Chief Editor: Richard A Lange, MD, MBA  more...
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Diagnostic Considerations

Libman-Sacks can be considered a diagnostic of exclusion.

Initially, evaluation for more severe pathologies such as infective endocarditis should be performed. The modified Duke criteria utilizing pathologic and clinical criteria can be useful in helping to differentiate between true infective endocarditis and Libman–Sacks endocarditis.

Other conditions to consider in the differential diagnosis of Libman-Sacks endocarditis include the following:

  • Degenerative valvular disease

  • Fibroelastoma

  • Rheumatic valvular disease

  • Lambl excrescences (normal variant) - These are filiform strands that originate at valve closure sites; they are thought to be normal variants, but some reports have proposed embolic potential [11]

Differential Diagnoses