Complete congenital heart block in the offspring of an asymptomatic woman with isolated high titer anti-ro antibody
https://actamedicaphilippina.upm.edu.ph/index.php/acta/article/view/6358/4234
- Author:
Kristine Niña Y. Limquiaco
1
;
Evelyn O. Salido
1
Author Information
1. Division of Rheumatology, Department of Medicine, Philippine General Hospital, University of the Philippines Manila
- Publication Type:Case Reports
- Keywords:
Neonatal lupus;
Congenital complete heart block;
Positive anti-Ro
- From:
Acta Medica Philippina
2024;58(1):84-89
- CountryPhilippines
- Language:English
-
Abstract:
Among pregnant women, 1-2% are anti-Ro positive and while half of them have symptoms of connective tissue
disease, the rest are asymptomatic. The presence of anti-Ro is of concern because of the risk of congenital heart
block in the child.
We report the case of an asymptomatic 27-year-old G2P1(1001) woman, who presented with persistent fetal
bradycardia in her 21st week of gestation (AOG) and was found to have elevated titers for anti-Ro (>320 U/ml).
Hydroxychloroquine 200 mg/day and prednisone 10 mg/day were given from the 33rd week of gestation up until the delivery. At 37 weeks AOG, she delivered a live male neonate with a complete heart block. On the 6th day of life, the infant remained bradycardic, hence a pacemaker was inserted and heart rate maintained at 100-120 bpm. On subsequent follow-ups, the mother and child did not develop any systemic manifestations and the infant was thriving well.
While a diseased condition may not be apparent in a pregnant anti-Ro positive woman, the risk of neonatal lupus (NL) is demonstrated in this patient’s case. This report illustrates how prenatal care of an asymptomatic woman led to the discovery of a fetal abnormality and served to prepare the family and the medical team to ably handle the birth and subsequent care of a neonate with NL.
- Full text:6358-Article Text-93868-2-10-20240125.pdf
