A combination therapy to treat second-degree anti-Ro/La-related congenital heart block. A strategy to avoid stable third-degree heart block?

作者：Ruffatti A^*; Milanesi O; Chiandetti L; Cerutti A; Gervasi M T; De Silvestro G; Pengo V; Punzi L

来源：Lupus, 2012, 21(6): 666-671.

DOI：10.1177/0961203311430969

• Cardiovascular diseases
• congenital heart block
• neonatal lupus
• pregnancy

While mainly based on the use of fluorinated steroids, there is no standard management of anti-Ro/La-related congenital heart block (CHB). This is a report concerning two consecutive cases of anti-Ro/La-related second-degree block treated with betamethasone (4 mg/day), weekly plasmapheresis, and intravenous immunoglobulins (IVIGs; 1 g/kg) administered every 15 days, a therapy that was begun shortly after CHB was detected and continued until delivery. The newborns were also treated with IVIG (1 g/kg) soon after birth and continued fortnightly until the anti-Ro/La antibody levels became undetectable. In both cases second-degree AV block reverted to a stable sinus rhythm with a first-degree atrioventricular (AV) block. Moreover, there was no recurrence of CHB when therapy was suspended, as confirmed by a 29 month and an eight month follow-up, respectively. Lupus (2012) 21, 666-671.

• 出版日期2012-5