Pérez-Juárez F, Mier-Martínez M, Morales-Garnica GA, Rubio-Neira M

Language: Spanish
References: 16
Page: 141-144
PDF size: 182.31 Kb.

ABSTRACT

Background: Neonatal lupus erythematosus is an infrequent systemic disease with an incidence of 1/10,000-20,000 newborns. Even though multi-systemic disease can be observed, the most common clinical presentations are either cutaneous or cardiac; the latter is the most severe presentation form, associated with high morbidity and mortality rates. Complete atrioventricular block is the most common clinical presentation of cardiac lupus. Objective: Description of two cases of complete atrioventricular block associated with lupus erythematosus. Clinical cases: The clinical cases of two prenatally diagnosed patients showing complete atrioventricular block associated with lupus erythematosus that required pacemaker implantation at birth are reported. Conclusions: Neonatal complete atrioventricular block is infrequent and it is associated with neonatal lupus erythematosus. For pregnant patients diagnosed with an autoimmune disease and/or anti-Ro and/or anti-LA antibodies, serial echocardiographic studies from the 20th week of gestation are recommended, in order to detect complete atrioventricular block and implement in utero intervention treatment. Neonatal lupus diagnosis requires a high level of suspicion and an adequate and multidisciplinary follow-up during pregnancy and in the newborn period is fundamental.

REFERENCES

1. Rosiles G, Hernández V, Correa Y, Almendarez FC, Berrón PR. Anticuerpos Anti SSA/Ro y SSB/La en el lupus neonatal. Reporte de un caso y revisión de la literatura. Alergia e Inmunol Pediatr. 2000; 9 (1): 16-20.

2. Chacón R, Tapia L, Cabrera R, Gutiérrez M. Lupus eritematoso neonatal: revisión de casos en los últimos 5 años. Reumatol Clin. 2014; 10 (3): 170-173.

3. Dey M, Jose T, Shrivastava A, Wadhwa RD, Agarwal R, Nair V. Complete congenital fetal heart block: a case report. Ob Gyn. 2014; 6 (1): 39-42.

4. Noronha M, Czarnobay G, Kiszewski A. Congenital and neonatal lupus erythematosus: two case reports. An Bras Dermatol. 2012; 87 (4): 625-628.

5. Capone C, Buyon J, Friedman D, Frishman W. Cardiac manifestations of neonatal lupus: a review of autoantibody associated congenital heart block and its impact in an adult population. Cardiol Rev. 2012; 20 (2): 72-76.

6. Lun K, Leung A. Neonatal lupus erythematosus. Autoimmune Dis. 2012; 4: 274-301.

7. Comas C, Mortera C, Figueras J, Guerola M, Mulet J, VIcenç C et al. Bloqueo auriculoventricular completo congénito: diagnóstico prenatal y manejo perinatal. Rev Esp Cardiol. 1997; 50 (7): 498-506.

8. McKinlay JR, Cooke LM, Cunningham BB, Gibbs NF. Neonatal lupus erythematosus. J Am Board Fam Med. 2001; 14: 21-27.

9. Aguilera P, Vicente A, González M. Neonatal lupus erythematosus. Semin Fund Esp Reumatol. 2011; 12 (1): 15-20.

10. Buyon JP, Waltock J, Kleinman C, Copel J. In utero identification and therapy of congenital heart block. Lupus. 1995; 4: 116-121.

11. Waltuck J, Buyon JP. Autoantibody-associated congenital heart block: outcome in mothers and children. Ann Intern Med. 1994; 120: 544-551.

12. Michaelsson M, Engle MA. Congenital complete heart block: an international study of the natural history. Cardiovasc Clin. 1972; 4: 85-101.

13. Rahman A, Isenberg D A. Systemic lupus erythematosus. N Engl J Med. 2008; 358: 929-939.

14. Friedman D, Kim M, Copel J, Davis C, Phoon C, Glickstein J et al. Utility of cardiac monitoring in fetuses at risk for congenital heart block: the PR Interval and Dexamethasone Evaluation (PRIDE) prospective study. Circulation. 2008; 117: 485-493.

15. Lee LA. Neonatal lupus: clinical features and management. Paediatr Drugs. 2014; 6: 71-78.

16. Yildirim A, Tunaoölu F, Türkmen A. Neonatal congenital heart block. Indian Pediatrics. 2013; 50: 156-168.