Autoimmune congenital heart block: a case report and review of the literature related to pathogenesis and pregnancy management

被引：3
作者：
Huang, Ying [1 ,2 ]
Deng, Jialin [1 ,2 ]
Liu, Jinghua [3 ]
Yang, Fangyuan [1 ,2 ]
He, Yi [1 ,2 ]
机构：
[1] Southern Med Univ, Affiliated Hosp 3, Dept Rheumatol & Immunol, 183 Zhongshan Ave West, Guangzhou 510630, Peoples R China
[2] Acad Orthoped, Inst Clin Immunol, Guangzhou, Guangdong Provi, Peoples R China
[3] Southern Med Univ, Affiliated Hosp 3, Dept Pediat, Guangzhou, Peoples R China
来源：
ARTHRITIS RESEARCH & THERAPY | 2024年 / 26卷 / 01期
关键词：
Anti-Ro/SSA antibody; Anti-La/SSB antibody; Autoimmune congenital heart block; Pregnancy management; Rheumatic diseases; 3RD-DEGREE ATRIOVENTRICULAR-BLOCK; ANTI-SSA/RO; ANTINUCLEAR ANTIBODIES; NEONATAL LUPUS; RHEUMATOLOGY GUIDELINE; GENERAL-POPULATION; FETUSES; INTERFERON; WOMEN; PREVALENCE;
D O I：
10.1186/s13075-023-03246-w
中图分类号：
R5 [内科学];
学科分类号：
1002 ; 100201 ;
摘要：
Autoimmune congenital heart block (ACHB) is a passively acquired immune-mediated disease characterized by the presence of maternal antibodies against components of the Ro/SSA and La/SSB ribonucleoprotein complex that mainly affects the cardiac conducting system. ACHB occurs in 2% of women with positive anti-Ro/SSA and anti-La/SSB antibodies and causes a high risk of intrauterine fetal death, neonatal mortality, and long-term sequelae. In this review, we first describe a case of ACHB to provide preliminary knowledge. Then, we discuss the possible pathogenic mechanisms of ACHB; summarize the pregnancy management of patients with positive anti-Ro/SSA and anti-La/SSB antibodies and/or rheumatic diseases, the prevention of ACHB, and the treatment of ACHB fetuses; and propose routine screening of these antibodies for the general population. Careful follow-up, which consists of monitoring the fetal heart rate, is feasible and reassuring for pregnant women with positive anti-Ro/SSA and/or anti-La/SSB antibodies to lower the risk of ACHB in fetuses. Moreover, maternal administration of hydroxychloroquine may be useful in preventing ACHB in pregnant women with anti-Ro/SSA and/or anti-La/SSB antibodies.
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页数：10
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