Persistent fetal sinus bradycardia associated with maternal anti-SSA/Ro and anti-SSB/La antibodies.

Abstract

OBJECTIVE:

To study the clinical course and outcome of fetal sinus bradycardia (SB) due to maternal antibody-induced sinus node dysfunction.

METHODS:

We reviewed the maternal, prenatal, and postnatal findings of fetuses with SB associated with elevated maternal anti-SSA/Ro and anti-SSB/La antibodies.

RESULTS:

Of the 6 cases diagnosed prenatally, 3 had isolated SB persisting after birth and had a good prognosis. Three fetuses with SB and severe myocardial involvement (congenital complete heart block and/or endocardial fibroelastosis) succumbed in utero in spite of treatment. Postmortem histopathology in 1 fetus showed inflammatory destruction of the sinus and atrioventricular nodes. SB was detected incidentally in a 7-year-old girl. She had intermittent heart block with progressive sinus arrest requiring permanent pacemaker.

CONCLUSION:

Fetal SB associated with maternal autoantibodies may persist in childhood, with a good prognosis in the absence of widespread cardiac involvement.

• Authors: Priya Chockalingam, Edgar T Jaeggi, Lukas A Rammeloo, Monique C Haak, Phebe N Adama van Scheltema, Johannes M P J Breur, Margot M Bartelings, Sally-Ann B Clur, Nico A Blom
• Journal: The Journal of rheumatology (J Rheumatol) Vol. 38 Issue 12 Pg. 2682-5 (Dec 2011) ISSN: 0315-162X [Print] Canada
• PMID: 22089457 (Publication Type: Case Reports, Journal Article)

Chemical References

• Antibodies, Antinuclear
• Autoantigens
• Ribonucleoproteins
• SS-A antibodies
• SS-A antigen
• SS-B antibodies
• SS-B antigen

Topics

• Adult
• Antibodies, Antinuclear (immunology)
• Autoantigens (immunology)
• Bradycardia (immunology, physiopathology)
• Child
• Child, Preschool
• Female
• Fetus (immunology, pathology, physiopathology)
• Heart Block (congenital, immunology, physiopathology)
• Humans
• Pregnancy (immunology)
• Ribonucleoproteins (immunology)
• Sick Sinus Syndrome (immunology, physiopathology)