BACKGROUND: Autoimmune fetal congenital heart block (CHB) is the most severe manifestation of neonatal lupus, and it is seen when maternal autoimmune antibodies cross the placenta and damage the AV node of the fetus. CHB is mainly associated with maternal SLE with anti-Ro/SSA- and anti-La/SSB-positive status, and incidence of CHB increases when both the antibodies are present. This study was conducted to know the incidence of fetal CHB in patients of SLE who had ANA, anti-Ro/SSA and anti-La/SSB positivity. METHODS: A prospective study was conducted in a tertiary-care teaching hospital of Indian Armed Forces between Jan 2012 to Sep 2014 where 13 cases of SLE were studied. All these patients were tested for ANA, anti-Ro/SSA and anti-La/SSB antibodies and fetal heart abnormalities. Fetuses with CHB were treated with steroids. RESULTS: Incidence of SLE was 0.14 %, 92 % of SLE patients were positive for ANA, and 46 % had anti-Ro/SSA- and anti-La/SSB-positive status. Two fetuses had congenital heart block, and one fetus required pacemaker placement 5 months after delivery. CONCLUSION: All the fetal congenital heart blocks are associated with maternal anti-Ro/SSA and anti-La/SSB and ANA antibodies. Treatment by steroids may improve the outcome in early stages of fetal CHB, and delivery with follow-up should be planned in a tertiary-care center where pacemaker placement facility is available.
BACKGROUND:Autoimmune fetal congenital heart block (CHB) is the most severe manifestation of neonatal lupus, and it is seen when maternal autoimmune antibodies cross the placenta and damage the AV node of the fetus. CHB is mainly associated with maternal SLE with anti-Ro/SSA- and anti-La/SSB-positive status, and incidence of CHB increases when both the antibodies are present. This study was conducted to know the incidence of fetal CHB in patients of SLE who had ANA, anti-Ro/SSA and anti-La/SSB positivity. METHODS: A prospective study was conducted in a tertiary-care teaching hospital of Indian Armed Forces between Jan 2012 to Sep 2014 where 13 cases of SLE were studied. All these patients were tested for ANA, anti-Ro/SSA and anti-La/SSB antibodies and fetal heart abnormalities. Fetuses with CHB were treated with steroids. RESULTS: Incidence of SLE was 0.14 %, 92 % of SLEpatients were positive for ANA, and 46 % had anti-Ro/SSA- and anti-La/SSB-positive status. Two fetuses had congenital heart block, and one fetus required pacemaker placement 5 months after delivery. CONCLUSION: All the fetal congenital heart blocks are associated with maternal anti-Ro/SSA and anti-La/SSB and ANA antibodies. Treatment by steroids may improve the outcome in early stages of fetal CHB, and delivery with follow-up should be planned in a tertiary-care center where pacemaker placement facility is available.
Authors: A Brucato; A Doria; M Frassi; G Castellino; F Franceschini; D Faden; M Pia Pisoni; L Solerte; M Muscarà; A Lojacono; M Motta; I Cavazzana; A Ghirardello; F Vescovi; V Tombini; R Cimaz; P F Gambari; P L Meroni; B Canesi; A Tincani Journal: Lupus Date: 2002 Impact factor: 2.911
Authors: Deborah M Friedman; Carolina Llanos; Peter M Izmirly; Brigit Brock; John Byron; Joshua Copel; Karen Cummiskey; Mary Anne Dooley; Jill Foley; Cornelia Graves; Colleen Hendershott; Richard Kates; Elena V Komissarova; Michelle Miller; Emmanuelle Paré; Colin K L Phoon; Tracy Prosen; Dale Reisner; Eric Ruderman; Philip Samuels; Jerry K Yu; Mimi Y Kim; Jill P Buyon Journal: Arthritis Rheum Date: 2010-04
Authors: N Costedoat-Chalumeau; Z Amoura; D Le Thi Hong; B Wechsler; D Vauthier; P Ghillani; T Papo; O Fain; L Musset; J-C Piette Journal: Ann Rheum Dis Date: 2003-10 Impact factor: 19.103
Authors: Lynne E Nield; Earl D Silverman; Jeffrey F Smallhorn; Glenn P Taylor; J Brendan M Mullen; Leland N Benson; Lisa K Hornberger Journal: J Am Coll Cardiol Date: 2002-08-21 Impact factor: 24.094
Authors: Deborah M Friedman; Mimi Y Kim; Joshua A Copel; Carolina Llanos; Claudine Davis; Jill P Buyon Journal: Am J Cardiol Date: 2009-03-04 Impact factor: 2.778