Congenital complete heart block and SSA antibodies: Obstetric implications

Singsen, Bernhard H.; Akhter, Jeanette E.; Weinstein, Mary; Sharp, Gordon C.

doi:10.1016/s0002-9378(85)80039-9

Cited by 41 publications

(9 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The increased sensitivity for antibodies to SSA52 by LIA is also reported by others using another commercial LIA6 and was apparent in both the sera of SLE patients as well as SSc patients. Although antibodies to SSA are not specific for any of the autoimmune connective tissue diseases, these antibodies may be prognostic for the development of neonatal lupus and/or a congenital heart block 13,14. Interestingly, it has been reported recently that maternal autoantibodies directed to a specific epitope within the leucine zipper amino acid sequence 200–239 (p200) of the SSA52 protein correlate with prolongation of fetal atrioventricular time and heart block 15.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of a Novel Line‐Blot Immunoassay for the Detection of Antibodies to Extractable Nuclear Antigens

Damoiseaux¹,

Boesten²,

Giesen³

et al. 2005

Annals of the New York Academy of Sciences

View full text Add to dashboard Cite

We have evaluated the performance of a novel line-blot immunoassay (LIA; Mikrogen) and compared results with those obtained by CIE (in-house), ELISA (Pharmacia Diagnostics), and FEIA (Pharmacia Diagnostics). Sera from systemic lupus erythematosus (SLE) patients (n = 123), systemic sclerosis patients (n = 25), and healthy controls (n = 40) were analyzed for the presence of antibodies to RNP, Sm, SSA, SSB, CENP-B, Scl-70, and Jo-1. Reading of LIA results, as compared with a cutoff control, was performed by automatic analysis of the test strips. Because LIA enables recognition of separate subunits of RNP (68, A, and C), Sm (B and D), and SSA (52 and 60), at least two of the RNP antigens and either one of the Sm or SSA antigens should be detected for considering the test RNP, Sm, or SSA-positive, respectively. LIA had the highest sensitivity in patients with autoimmune connective tissue diseases: 131 specificities (not PO, PCNA, or histones), as compared with ELISA (121), FEIA (119), and CIE (80). However, LIA revealed three positive reactions in healthy controls; other assays were completely negative. LIA is better than CIE, but similar to ELISA and FEIA, in terms of detecting systemic sclerosis-associated antibodies (CENP-B and Scl-70). Furthermore, LIA had the highest sensitivity (17.9%) for the SLE-specific anti-Sm antibodies, as compared with ELISA (11.4%), CIE (8.1%), and FEIA (5.7%). Finally, anti-SSA antibodies were far more prevalent by LIA in the systemic sclerosis samples because of anti-SSA52 reactivity. The clinical relevance of the latter finding remains to be determined. In conclusion, LIA is suitable for routine evaluation of autoantibodies to extractable nuclear antigens.

show abstract

Section: Discussionmentioning

confidence: 99%

Evaluation of a Novel Line‐Blot Immunoassay for the Detection of Antibodies to Extractable Nuclear Antigens

Damoiseaux¹,

Boesten²,

Giesen³

et al. 2005

Annals of the New York Academy of Sciences

View full text Add to dashboard Cite

show abstract

“…These other antibodies were not measured here. Anti-RoSSA antibodies have been shown to cause fetal heart block [25][26][27], This may have occurred in some of our patients.…”

Section: Discussionmentioning

confidence: 94%

Fetal Demise Associated with Lupus Anticoagulant: Clinical Features and Results of Treatment

Carp

Frenkel

Many

et al. 1989

Gynecol Obstet Invest

View full text Add to dashboard Cite

There are many reports in the literature associating lupus anticoagulant with fetal death. Successful pregnancies have been reported following suppression of the antibody by prednisone and the addition of antiaggre-gants and possibly anticoagulants. This report describes our experience treating such patients and the outcome of subsequent pregnancies. The results are less successful than the figures in the literature, 13 live births out of 27 pregnancies in 19 patients. This may be due to lupus anticoagulant being diagnosed as the cause for a wide variety of clinical presentations including habitual first trimester abortion, mid trimester fetal death, intrauterine growth retardation and placental dysfunction in the third trimester. Our experience shows that steroids and antiaggregants have a definite place in cases of second and third trimester fetal death and in cases of clinical systemic lupus erythematosus. However, lupus anticoagulant is one of a spectrum of autoantibodies whose pathophysiology has not been fully elucidated. It is questionable whether this regimen of treatment has a place in patients with no previous fetal loss or in cases of primary habitual abortion.

show abstract

“…The fetal cardiac dysfunction usually appears in the second trimester of pregnancy (Scott et al 1983; Singsen et al 1985) after the heart has completed its main development. The defect is acquired, since normal heart rates and function have been observed before the development of complete heart block (Singsen et al 1985; Buyon et al 1987). The myocardial lesion is, apparently, specific for the fetus, with no evident heart disease in the mother.…”

Section: Discussionmentioning

confidence: 99%

“…Because the heart conduction defects usually develop in the second trimester of pregnancy (Scott et al 1983; Singsen et al 1985), at a time when there is increased transport of maternal antibodies across the placenta, treatment has been directed towards decreasing the quantity of maternal autoantibody, or to suppressing fetal myocarditis and specific inflammation of the conduction system. Plasmapheresis is unsuccessful in reversing established congenital heart block (Herreman & Galezewski 1985; Buyon et al 1987), but may prevent myocarditis and limit cardiac damage.…”

Section: Discussionmentioning

confidence: 99%