Nava-Rivera LE, Lozoya-Martínez R, Chi-Argüelles D, Morán-Martínez J

Language: English
References: 26
Page: 50-54
PDF size: 413.47 Kb.

ABSTRACT

One of the most common pathologies attributed to lupus neonatal refers to atrioventricular (AV) congenital block, which diagnosis can be made between 16 and 30 weeks of gestation due to persistent fetal bradycardia. The development of this disease is mostly related to maternal anti-Ro/SSA and anti-Smith autoantibodies. Currently, there are a number of alternatives for prenatal and postnatal treatment, with some controversy about their viability. The placement of a permanent pacemaker is presented as one of the most appropriate procedures currently, even with the risks awarded. This case report describes the placement of a permanent pacemaker to a two-month-old newborn with high maternal contents of anti-Ro/SSA and anti-Smith nuclear autoantibodies, with a favorable outcome.

REFERENCES

1. Buyon JP, Hiebert R, Copel J, Craft J, Friedman D, Katholi M et al. Autoimmune-associated congenital heart block: demographics, mortality, morbidity and recurrence rates obtained from a national neonatal lupus registry. J Am Coll Cardiol. 1998; 31 (7): 1658-1666.

2. Hunter LE, Simpson JM. Atrioventricular block during fetal life. J Saudi Heart Assoc. 2015; 27 (3): 164-178.

3. Ho SY, Esscher E, Anderson RH, Michaëlsson M. Anatomy of congenital complete heart block and relation to maternal anti-Ro antibodies. Am J Cardiol. 1986; 58 (3): 291-294.

4. Habash-Bseiso DE, Yale SH, Glurich I, Goldberg JW. Serologic testing in connective tissue diseases. Clin Med Res. 2005; 3 (3): 190-193.

5. Cozzani E, Drosera M, Gasparini G, Parodi A. Serology of Lupus Erythematosus: Correlation between Immunopathological Features and Clinical Aspects. Autoimmune Dis. 2014; 2014: 321359.

6. Maidhof W, Hilas O. Lupus: an overview of the disease and management options. P T. 2012; 37 (4): 240-249.

7. Gardiner HM, Belmar C, Pasquini L, Seale A, Thomas M, Dennes W et al. Fetal ECG: a novel predictor of atrioventricular block in anti-Ro positive pregnancies. Heart. 2007; 93 (11): 1454-1460.

8. Hunter LE, Simpson JM. Atrioventricular block during fetal life. J Saudi Heart Assoc. 2015; 27 (3): 164-178.

9. Friedman DM, Rupel A, Glickstein J, Buyon JP. Congenital heart block in neonatal lupus: the pediatric cardiologist’s perspective. Indian J Pediatr. 2002; 69 (6): 517-522.

10. Buyon JP, Clancy RM, Friedman DM. Autoimmune associated congenital heart block: integration of clinical and research clues in the management of the maternal / foetal dyad at risk. J Intern Med. 2009; 265 (6): 653-662.

11. Dey M, Jose T, Shrivastava A, Wadhwa RD, Agarwal R, Nair V. Complete congenital foetal heart block: a case report. Facts Views Vis Obgyn. 2014; 6 (1): 39-42.

12. Puri S, Pooni P, Mohan B, Bindal V, Verma S, Verma S et al. Pregnancy with SLE and fetal congenital heart block: a case report. Cardiol Res. 2013; 4 (3): 126-128.

13. Baruteau AE, Pass RH, Thambo JB, Behaghel A, Le Pennec S, Perdreau E et al. Congenital and childhood atrioventricular blocks: pathophysiology and contemporary management. Eur J Pediatr. 2016; 175 (9): 1235-1248.

14. Jaeggi ET, Hamilton RM, Silverman ED, Zamora SA, Hornberger LK. Outcome of children with fetal, neonatal or childhood diagnosis of isolated congenital atrioventricular block. A single institution’s experience of 30 years. J Am Coll Cardiol. 2002; 39 (1): 130-137.

15. Martínez-Sánchez N, Pérez-Pinto S, Robles-Marhuenda A, Arnalich-Fernández F, Martín-Cameán M, Hueso-Zalvide E et al. Obstetric and perinatal outcome in anti-Ro/SSA-positive pregnant women: a prospective cohort study. Immunol Res. 2017; 65 (2): 487-494.

16. Eronen M, Miettinen A, Walle TK, Chan EK, Julkunen H. Relationship of maternal autoimmune response to clinical manifestations in children with congenital complete heart block. Acta Paediatr. 2004; 93 (6): 803-809.

17. Ambrosi A, Salomonsson S, Eliasson H, Zeffer E, Skog A, Dzikaite V et al. Development of heart block in children of SSA/SSB-autoantibody-positive women is associated with maternal age and displays a season-of-birth pattern. Ann Rheum Dis. 2012; 71 (3): 334-340.

18. Berg C, Geipel A, Kohl T, Breuer J, Germer U, Krapp M et al. Atrioventricular block detected in fetal life: associated anomalies and potential prognostic markers. Ultrasound Obstet Gynecol. 2005; 26 (1): 4-15.

19. Fouron JC, Proulx F, Miró J, Gosselin J. Doppler and M-mode ultrasonography to time fetal atrial and ventricular contractions. Obstet Gynecol. 2000; 96 (5 Pt 1): 732-736.

20. Rein AJ, Mevorach D, Perles Z, Gavri S, Nadjari M, Nir A et al. Early diagnosis and treatment of atrioventricular block in the fetus exposed to maternal anti-SSA/Ro-SSB/La antibodies: a prospective, observational, fetal kinetocardiogram-based study. Circulation. 2009; 119 (14): 1867-1872.

21. Friedman DM, Llanos C, Izmirly PM, Brock B, Byron J, Copel J et al. Evaluation of fetuses in a study of intravenous immunoglobulin as preventive therapy for congenital heart block: Results of a multicenter, prospective, open-label clinical trial. Arthritis Rheum. 2010; 62 (4): 1138-1146.

22. Ruffatti A, Milanesi O, Chiandetti L, Cerutti A, Gervasi MT, De Silvestro G et al. A combination therapy to treat second-degree anti-Ro/La-related congenital heart block: a strategy to avoid stable third-degree heart block? Lupus. 2012; 21 (6): 666-671.

23. Lazzerini PE, Capecchi PL, Guideri F, Acampa M, Galeazzi M, Laghi Pasini F. Connective tissue diseases and cardiac rhythm disorders: an overview. Autoimmun Rev. 2006; 5 (5): 306-313.

24. Welch EM, Hannan RL, DeCampli WM, Rossi AF, Fishberger SB, Zabinsky JA et al. Urgent permanent pacemaker implantation in critically ill preterm infants. Ann Thorac Surg. 2010; 90 (1): 274-276.

25. Takabayashi S, Ito H, Shimpo H, Sawada H, Mitani Y, Komada Y. Emergent permanent pacemaker implantation in a premature 1,502 g neonate. Jpn J Thorac Cardiovasc Surg. 2005; 53 (4): 199-201.

26. Tomita Y, Imoto Y, Tominaga R, Yasui H. Successful implantation of a bipolar epicardial lead and an autocapture pacemaker in a low-body-weight infant with congenital atrioventricular block: report of a case. Surg Today. 2000; 30 (6): 555-557.