Complete Congenital Heart Block in a Neonatal Lupus Erythematosus Associated with Pulmonary Involvement without Pacemaker Implantation: A Case Report

Document Type : Case Report

Authors

1 Assistant Professor, Pediatric Cardiologist, Amirkabir Hospital, Arak University of Medical Sciences, Arak, Iran

2 Pediatric Resident, Amirkabir Hospital, Arak University of Medical Sciences, Arak, Iran

3 Assistant Professor, Neonatologist, Amirkabir Hospital, Arak University of Medical Sciences, Arak, Iran

4 Assistant Professor, Amiralmomenin Hospital, Department of Cardiac Surgery, School of Medicine, Arak University of Medical Sciences, Arak, Iran

Abstract

Background: Neonatal lupus erythematosus is an uncommon disease. Congenital complete heart block (CCHB) usually happens in neonates with maternal systemic lupus erythematosus. The most prevalent presentation of CCHBis bradycardiathatcanbediagnosed through an electrocardiogram.
Case report: Here in, we present the case of a full-term male neonate with gestational age of 37 weeks and birth weight of 2200 g, whose mother had positive anti-Ro/SSA antibodies. The mother was asymptomatic without any criteria of systemic lupus erythematosus. The newborn presented with bradycardia, respiratory distressand narrow QRS complex without structural heart disease. He was connected to mechanical ventilator and did not need pacemaker implantation.
Conclusion: This case report was conducted on a newborn with CCHB associated with pulmonary disorder. The newborn was intubated due to respiratory distress and did not need pacemaker implantation; however, after 8-month follow up, excellent outcomes were observed. It seems that atelectasis and mechanical ventilation can intolerance, and pacemaker implantation did not need in NLE with CCHB with narrowing QRS complex.

Keywords

References

  1. References

    1. Friedman DM, Duncanson LJ, Glickstein J, Buyon JP. A review of congenital heart block. Images Paediatr Cardiol. 2003; 5(3):36-48.
    2. Claus R, Hickstein H, Kulz T, Lenschow U, Meiske D, Kotitschke A, et al. Identification and management of fetuses at risk for, or affected by, congenital heart block associated with autoantibodies to SSA (Ro), SSB (La), or a HsEg5-like autoantigen. RheumatolInt. 2006; 26(10):886-95.
    3. Jaeggi E, Laskin C, Hamilton R, Silverman E. The importance of maternal anti-Ro/SSA antibodies as prognostic markers of the development of cardiac neonatal lupus erythematosus: a prospective study of 186 antibody-exposed fetuses and infants. J Am Coll Cardiol. 2010; 55(24):2778–84.
    4. Costedoat-Chalumeau N, Amoura Z, Lupoglazoff JM, Huong DL, Denjoy I, Vauthier D, et al. Outcome of pregnancies in patients with anti-SSA/Ro antibodies: a study of 165 pregnancies, with special focus on electrocardiographic variations in the children and comparison with a control group. Arthritis Rheum. 2004; 50(10):3187–94.
    5. Brucato A, Frassi M, Franceschini F, Cimaz R, Faden D, Pison MP, et al. A Risk of congenital complete heart block in newborns of mothers with anti-Ro/SSA antibodies detected by counterimmuno-electrophoresis: a prospective study of 100 women. Arthritis Rheum. 2001; 44(8):1832–5.
    6. Hutter D, Silverman ED, Jaeggi ET. The benefits of transplacental treatment of isolated congenital complete heart block associated with maternal anti-Ro / SSA antibodies: a review. Scand J Immunol. 2010; 72(3):235-41.
    7. Friedman DM, Kim MY, Copel JA, Davis C, Phoon CK, Glickstein JS, et al. Utility of cardiac monitoring in fetuses at risk for congenital heart block: the PR Interval and Dexamethasone Evaluation (PRIDE) prospective study. Circulation. 2008; 117(4):485-93.
    8. Ayed K, Gorgi Y, Sfar I, Khrouf M. Congenital heart block associated with maternal anti SSA/SSB antibodies: a report of four cases. Pathol Biol (Paris). 2004; 52(3):138-47.
    9. Jaeggi ET, Hamilton RM, Silverman ED, Zamora SA, Hornberger LK. Outcome of children with fetal, neonatal or childhood diagnosis of isolated congenital atrioventricular block. A single institution's experience of 30 years. J Am Coll Cardiol. 2002; 39(1):130-7.

    10. Moak JP, Barron KS, Hougen TJ, Wiles HB, Balaji S, Sreeram N, et al. Congenital heart block: development of late-onset cardiomyopathy, a previously underappreciated sequela. J Am Coll Cardiol. 2001; 37(1):238-42.

    11. Friedman DM, Rupel A, Glickstein J, Buyon JP. Congenital heart block in neonatal lupus: The pediatric cardiologist's perspective. Indian J Pediatr. 2002; 69(6):517-22.

Iranian Journal of Neonatology
Volume 7, Issue 3 - Serial Number 3
October 2016
Pages 29-32

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