The effect of a triple therapy on maternal anti-Ro/SS-A levels associated to fetal cardiac manifestations

Martínez-Sánchez, Nuria; Robles‐Marhuenda, Ángel; Alvarez-Doforno, R.; Viejo, Aurora; Antolín-Alvarado, Eugenia; Deiros-Bronte, Lucía; Bartha, José Luis

doi:10.1016/j.autrev.2015.01.005

Cited by 20 publications

(24 citation statements)

References 26 publications

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“…Long-term side effects of therapy to mother and baby are not known. In one case series, plasmapheresis, intravenous immunoglobulin and glucocorticoids together were used in positive anti-Ro/SSA antibody patients, with successful outcome in two of the three babies 4. Fetal echocardiography is recommended every 2 weeks starting from the 16th week of gestation to follow the progression of the disease.…”

Section: Discussionmentioning

confidence: 99%

Autoantibody-associated congenital heart block: a rare cause of persistent fetal bradycardia

Nigam

Ahmad

2015

BMJ Case Reports

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Section: Discussionmentioning

confidence: 99%

Autoantibody-associated congenital heart block: a rare cause of persistent fetal bradycardia

Nigam

Ahmad

2015

BMJ Case Reports

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“…When a CAVB is detected, the maternal therapy consists of steroids and beta‐agonists, whereas adjuvant therapies include TPE, IVIG, hydroxychloroquine and other immunosuppressive agents. Martínez‐Sánchez et al () reported three cases of fetuses with mild cardiac involvement in which the disease was halted by TPE, IVIG and steroids, not requiring a pacemaker. Ruffatti et al () reported 12 cases of CAVB where a combination protocol of weekly TPE, fortnightly IVIG and daily betamethasone were administered throughout pregnancy.…”

Section: Tpe In Non‐haematological Autoimmune Disordersmentioning

confidence: 99%

The role of plasma exchange in the management of autoimmune disorders

Zanatta

Cozzi²,

Marson

et al. 2019

Br J Haematol

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Summary Therapeutic plasma exchange (TPE) has been mainly used in the treatment of autoimmune diseases. The main mechanisms of action of TPE include the removal of circulating autoantibodies, immune complexes, complement components, cytokines and adhesion molecules, along with sensitization of antibody‐producing cells to immunosuppressant agents. TPE is useful in autoimmune haematological, renal, rheumatic and neurological diseases, and is recommended for acute disorders, together with relapsed or worsened chronic diseases that are often unresponsive to conventional treatments. The American Society for Apheresis and the British Society of Haematology have published guidelines on the clinical use of apheresis procedures, indicating the different levels of efficacy of TPE. Based on the evidence from current literature and our personal experience, this review discusses the indications and the suggested regimens for TPE in autoimmune haematological and non‐haematological disorders.

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“…Placental transfer of maternal IgG antibodies from Week 16 onwards resulted in damaging the cardiac electro‐conduction system despite a structurally normal heart . Electro‐conduction damage varies from reversible to irreversible and fatal heart block . IgG antibodies potentially mediate their effect by inducing inflammatory immune reactions on the atrioventricular (AV) transduction .…”

Section: New Diseases – Category IIImentioning

confidence: 99%

“…IgG antibodies potentially mediate their effect by inducing inflammatory immune reactions on the atrioventricular (AV) transduction . Inflammatory reactions cause fibrosis and thus lead to CHB …”

Section: New Diseases – Category IIImentioning

confidence: 99%

“…TPE, which is category III treatment for CHB, has been used as an adjuvant therapy to steroids or IVIG to decrease maternal antibody titers of anti‐Ro/SSA and anti‐La/SSB . Maternal antibodies decreased with cycles of plasma exchange and IVIG treatments, with the most profound reduction after the first cycle . Triple therapy using a combination of steroids, IVIG and TPE, while effective, it did not prevent development of CHB .…”

Section: New Diseases – Category IIImentioning

confidence: 99%

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Critical updates in the 7^th edition of the American Society for Apheresis guidelines

Ipe

Pham

Williams

2017

J of Clinical Apheresis

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The 7 th edition of the American Society for Apheresis (ASFA) guidelines was composed by an international physicians committee, and includes 14 new diseases, and 2 new indications for diseases described in the former guidelines. Several indications have either changed names or were excluded from this edition. The guidelines are developed after taking into account documented evidence, either supporting or negating use of apheresis technology in the treatment of diseases. Based on this evidence, the committee revises, updates and includes or excludes disease entities/indications in the guidelines. This article describes the revisions to the 7 th edition of the ASFA guidelines, in a comprehensive manner. K E Y W O R D Sapheresis, ASFA guidelines, critical updates, diseases and indications, 7th edition

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The effect of a triple therapy on maternal anti-Ro/SS-A levels associated to fetal cardiac manifestations

Cited by 20 publications

References 26 publications

Autoantibody-associated congenital heart block: a rare cause of persistent fetal bradycardia

Autoantibody-associated congenital heart block: a rare cause of persistent fetal bradycardia

The role of plasma exchange in the management of autoimmune disorders

Critical updates in the 7^th edition of the American Society for Apheresis guidelines

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The effect of a triple therapy on maternal anti-Ro/SS-A levels associated to fetal cardiac manifestations

Cited by 20 publications

References 26 publications

Autoantibody-associated congenital heart block: a rare cause of persistent fetal bradycardia

Autoantibody-associated congenital heart block: a rare cause of persistent fetal bradycardia

The role of plasma exchange in the management of autoimmune disorders

Critical updates in the 7th edition of the American Society for Apheresis guidelines

Contact Info

Product

Resources

About

Critical updates in the 7^th edition of the American Society for Apheresis guidelines