Identification of mothers at risk for congenital heart block and other neonatal lupus syndromes in their children. comparison of enzyme‐linked immunosorbent assay and immunoblot for measurement of anti–ss‐a/ro and anti–ss‐b/la antibodies

Buyon, Jill P.; Winchester, Robert; Slade, Seth G.; Arnett, Frank C.; Copel, Joshua A.; Friedman, Deborah; Lockshin, Michael D.

doi:10.1002/art.1780360911

Cited by 191 publications

(78 citation statements)

References 33 publications

(20 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Anti-SSA/Ro and anti-SSB/La antibodies were present in 91 % of mothers of infants with complete heart block, 73 % of mothers of infants with transient cutaneous neonatal lupus, and 15 % of mothers with lupus and related autoimmune diseases who gave birth to healthy infants [6,7].…”

Section: Epidemiologymentioning

confidence: 99%

Neonatal Lupus Erythematosus

Nasef

Hafez²,

Bakr³

2014

NCP

View full text Add to dashboard Cite

Neonatal lupus is a passively acquired autoimmune disease that occurs in offspring of mothers with anti-SSA/Ro and/or anti-SSB/La antibodies. The primary clinical features are a photosensitive rash that is usually found on the scalp and periorbital areas, congenital heart block with or without cardiomyopathy, cytopenias, disseminated intravascular coagulation, and neonatal cholestasis with or without elevated transaminases. The diagnosis is usually made in utero by detection of a slow fetal heart rate and subsequent fetal echocardiographic confirmation of heart block and/or cardiomyopathy. Prenatal treatment with fluorinated glucocorticoids beginning as soon after detection has favourable outcome for mothers of fetuses with second degree heart block, is of no value for mothers of fetuses with third degree heart block, and controversial for mothers of fetuses with first degree heart block. Prenatal glucocorticoids can be used also in presence of cardiomyopathy associated with neonatal lupus. Hydroxychloroquine has been used in pregnant women who have anti-SSA/Ro antibodies and who have previously given birth to a child with cardiac manifestations. First and second degree block, detected in utero or at birth, can progress to complete heart block. Infants with complete heart block usually require a pacemaker with an excellent prognosis, although development of heart failure may occur.

show abstract

Section: Epidemiologymentioning

confidence: 99%

Neonatal Lupus Erythematosus

Nasef

Hafez²,

Bakr³

2014

NCP

View full text Add to dashboard Cite

show abstract

“…The most serious manifestation, congenital complete heart block may result when maternal autoantibodies (anti-SS-A/Ro and anti-SS-B/La) bind to fetal cardiac antigens. (Buyon et al 1993) Based on experimental studies in which SLE is induced by administration of parental cells into the progeny, a potential role for maternal Mc in NLS is suggested. Maternal cells were recently detected in the hearts of male infants with NLS who died from congenital heart block.…”

Section: B Maternal Microchimerism In Type I Diabetes Mellitus and Nmentioning

confidence: 99%

Autoimmune Disease During Pregnancy and the Microchimerism Legacy of Pregnancy

Waldorf

Nelson

2008

Immunological Investigations

156

137

View full text Add to dashboard Cite

Pregnancy has both short-term effects and long-term consequences. For women who have an autoimmune disease and subsequently become pregnant, pregnancy can induce amelioration of the mother's disease, such as in rheumatoid arthritis, while exacerbating or having no effect on other autoimmune diseases like systemic lupus erythematosus. That pregnancy also leaves a long-term legacy has recently become apparent by the discovery that bi-directional cell trafficking results in persistence of fetal cells in the mother and of maternal cells in her offspring for decades after birth. The long-term persistence of a small number of cells (or DNA) from a genetically disparate individual is referred to as microchimerism. While microchimerism is common in healthy individuals and is likely to have health benefits, microchimerism has been implicated in some autoimmune diseases such as systemic sclerosis. In this paper, we will first discuss short-term effects of pregnancy on women with autoimmune disease. Pregnancy-associated changes will be reviewed for selected autoimmune diseases including rheumatoid arthritis, systemic lupus erythematosus and autoimmune thyroid disease. The pregnancy-induced amelioration of rheumatoid arthritis presents a window of opportunity for insights into both immunological mechanisms of fetal-maternal tolerance and pathogenic mechanisms in autoimmunity. A mechanistic hypothesis for the pregnancy-induced amelioration of rheumatoid arthritis will be described. We will then discuss the legacy of maternal-fetal cell transfer from the perspective of autoimmune diseases. Fetal and maternal microchimerism will be reviewed with a focus on systemic sclerosis (scleroderma), autoimmune thyroid disease, neonatal lupus and type I diabetes mellitus.Keywords autoimmune disease; pregnancy; microchimerism; systemic lupus erythematosus; rheumatoid arthritis PREGNANCY IN WOMEN WITH PRE-EXISTING AUTOIMMUNE DISEASEAutoimmune disease may complicate pregnancy in many different ways adding to the immunologic challenges already faced by the mother. The maternal immune system must avoid rejecting a semi-allogeneic fetus, remain immunocompetent to fight infections, and clear abnormal cells (e.g. precancerous) that could be harmful to the mother or fetus. Symptoms of an autoimmune disease could improve, worsen, or remain unchanged when a et al. 1987) In contrast, only a weak association between SLE susceptibility and HLA-DRB1*15 or DRB1*03 has been found in specific ethnic groups; it has been suggested that these associations are instead related to genes in linkage disequilibrium (e.g. gene encoding tumor necrosis factor-alpha with HLA-DRB1*15). (Jacob et al. 1990;Vyse and Kotzin 1998) Sex hormones and the immunologic effects of pregnancy have been investigated in autoimmunity. The well-studied relationship between sex hormones and lupus-like disease in animal models suggests a contributory role for estrogen in disease exacerbation and possibly in disease susceptibility. SLE may occur more frequently in women who have ...

show abstract

“…Maternal antibody profiles were similar between affected and unaffected infants, suggesting that antibody passage to the fetus by itself is not sufficient to cause CHB (10). Clearly, if anti-Ro/SS-A andlor anti-La/SS-B antibodies are involved, the mechanism is complex and more than the existence of the antibodies is required to cause disease.…”

Section: Neonatal Lupus Erythematosus: Haplotypic Analysis Of Hla Clamentioning

confidence: 99%

Neonatal lupus erythematosus: Haplotypic analysis of HLA class II alleles in child/mother pairs

Miyagawa

Fukumoto

Hashimoto

et al. 1997

Arthritis & Rheumatism

View full text Add to dashboard Cite

Identification of mothers at risk for congenital heart block and other neonatal lupus syndromes in their children. comparison of enzyme‐linked immunosorbent assay and immunoblot for measurement of anti–ss‐a/ro and anti–ss‐b/la antibodies

Abstract: Objective. To identify the fine specificity patterns of maternal anti-SS-AIR0 and anti-SS-B/La antibodies that are associated with the birth of a child with transient or permanent manifestations of neonatal lupus syndromes, and to suggest a predictor algorithm for use in counseling.

Cited by 191 publications

References 33 publications

Neonatal Lupus Erythematosus

Neonatal Lupus Erythematosus

Autoimmune Disease During Pregnancy and the Microchimerism Legacy of Pregnancy

Neonatal lupus erythematosus: Haplotypic analysis of HLA class II alleles in child/mother pairs

Contact Info

Product

Resources

About