Autoimmune-mediated congenital heart block

Wainwright, Benjamin J.; Bhan, Rohit; Trad, Catherine; Cohen, Rebecca E.; Saxena, Amit; Buyon, Jill P.; Izmirly, Peter

doi:10.1016/j.bpobgyn.2019.09.001

Cited by 52 publications

(54 citation statements)

References 69 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The risk of intrauterine death was 6% and the overall survival rate at 10 years was 86%. Seventy percent of children required pacing by 10 years of age [ 25 ]. Predictive factors of intrauterine death were hydrops and earlier gestational age at the time of cardiac manifestation onset, while predictive factors of neonatal death were hydrops and endocardial fibroelastosis [ 26 ].…”

Section: Pregnancy In Women With Anti-ro/ssa Antibodiesmentioning

confidence: 99%

“…The risk of developing a congenital fetal heart block varies between 0.2–2% in nulliparous women with positive anti-Ro antibodies, and increases to 15–20% in pregnancies with a previously affected fetus or neonate [ 25 , 32 ]. Women who had two previously affected pregnancies have a risk of 50% of fetal CHB in subsequent pregnancies [ 31 ].…”

Section: Pregnancy In Women With Anti-ro/ssa Antibodiesmentioning

confidence: 99%

“…To summarize, the risk factors for developing CHB are: positive anti-Ro/SSA and/or anti-La/SSB mothers, high titers of anti-Ro, a previous baby with CHB, cutaneous neonatal lupus in a sibling, lack of prophylactic treatment with hydroxychloroquine, predisposing fetal genes (e.g., SNPs within the HLA region [ 105 ], TGF-beta polymorphisms [ 25 , 45 ], IFN-stimulated genes [ 106 ]. Thus, in these situations, close monitoring and prophylactic treatment should be started as soon as possible, to prevent CHB occurrence.…”

Section: Management Of Positive Anti-ro/ssa Pregnanciesmentioning

confidence: 99%

“…700/year in the United States) of potential congenital heart block (CHB) cases. Still, a large proportion of the anti-Ro positive, asymptomatic women will get pregnant without ever being tested [ 25 ].…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

A Broader Perspective on Anti-Ro Antibodies and Their Fetal Consequences—A Case Report and Literature Review

Popescu

Dudu²,

Jurcuţ³

et al. 2020

Diagnostics

View full text Add to dashboard Cite

The presence of maternal Anti-Ro/Anti-La antibodies causes a passively acquired autoimmunity that may be associated with serious fetal complications. The classic example is the autoimmune-mediated congenital heart block (CHB) which is due in most cases to the transplacental passage of Anti-Ro/Anti-La antibodies. The exact mechanisms through which these pathologic events arise are linked to disturbances in calcium channels function, impairment of calcium homeostasis and ultimately apoptosis, inflammation and fibrosis. CHB still represents a challenging diagnosis and a source of debate regarding the best management. As the third-degree block is usually irreversible, the best strategy is risk awareness and prevention. Although CHB is a rare occurrence, it affects one in 20,000 live births, with a high overall mortality rate (up to 20%, with 70% of in utero deaths). There is also concern over the lifelong consequences, as most babies need a pacemaker. This review aims to offer, apart from the data needed for a better understanding of the issue at hand, a broader perspective of the specialists directly involved in managing this pathology: the rheumatologist, the maternal–fetal specialist and the cardiologist. To better illustrate the theoretical facts presented, we also include a representative clinical case.

show abstract

Section: Pregnancy In Women With Anti-ro/ssa Antibodiesmentioning

confidence: 99%

Section: Pregnancy In Women With Anti-ro/ssa Antibodiesmentioning

confidence: 99%

Section: Management Of Positive Anti-ro/ssa Pregnanciesmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

A Broader Perspective on Anti-Ro Antibodies and Their Fetal Consequences—A Case Report and Literature Review

Popescu

Dudu²,

Jurcuţ³

et al. 2020

Diagnostics

View full text Add to dashboard Cite

show abstract

“…EFE is a rare heart disease characterized by thickening of the endocardium, cardiac enlargement, and myocardial dysfunction. The exact etiology of EFE is unknown and may be related to many factors, including infection [1], congenital developmental malformation [2], autoimmune diseases [3], chromosomal abnormalities and gene mutations [4], and myocardial ischemia and hypoxia [5]. It is one of the causes of heart failure in infants and children [6,7].…”

Section: Discussionmentioning

confidence: 99%

Incremental Value of 3D and Contrast Echocardiography in Evaluation of Endocardial Fibroelastosis and Multiple Cardiovascular Thrombi

Sun¹,

Li²,

Qiao³

et al. 2020

Preprint

View full text Add to dashboard Cite

Background: Endocardial fibroelastosis (EFE) is a rare heart disease characterized by the thickening of the endocardium caused by massive proliferation of collagenous and elastic tissue, usually leading to impaired cardiac function. Thrombosis is a complication of EFE that suggests poor prognosis.Case presentation: The present report describes an EFE patient with multiple cardiovascular thrombi. To the best of our knowledge, this is the first reported case of three-dimensional (3D) and contrast echocardiography use in EFE with multiple ventricular thrombi. The clinical features and outcomes of this rare condition between 1966 and 2019 are also reviewed.Conclusions: Through the combination of 3D and contrast echocardiography, the thrombus can be displayed more accurately and vividly, including its nature and density and the connection between the base of the thrombus and ventricular wall. EFE prognosis with left ventricular thrombus is generally poor.

show abstract