Primary Sjögren's syndrome--treatment of fetal incomplete atrioventricular block with dexamethasone.
Pregnancies in women with autoantibodies against Ro/SSA and/or La/SSB may be associated with permanent and treatment resistant fetal atrioventricular (AV) block. We describe a patient with primary S ogren's syndrome and anti-Ro (60 kDa and 52 kDa) and anti-La autoantibodies, in whom fetal bradycardia with second-degree AV block was detected at 19 + 0 weeks of gestation. Maternal treatment with dexamethasone (4 mg/day po) was started 2 days later. The baby's heart rate improved gradually, returning to normal after about 6 weeks of treatment. Our case illustrates the importance of close monitoring of the fetal heart rate in risk-pregnancies from about week 16 of gestation and initiation of dexamethasone treatment without delay when a block is detected.
Sjögren's Syndrome Research Centre, Department of Rheumatology, University Hospital of Malmö, Lund University, Stockholm, Sweden. elke.theander@medforsk.mas.lu.se
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E
Theander
A
A
Brucato
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S
Gudmundsson
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S
Salomonsson
M
M
Wahren-Herlenius
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R
Manthorpe
D000328:Adult; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage* / Q000009:adverse effects; D000974:Antibodies, Antinuclear / Q000009:adverse effects / Q000097:blood / Q000276:immunology; D003907:Dexamethasone / Q000008:administration & dosage* / Q000009:adverse effects; D005260:Female; D005315:Fetal Diseases / Q000175:diagnosis / Q000188:drug therapy / Q000276:immunology*; D006327:Heart Block / Q000151:congenital* / Q000188:drug therapy / Q000276:immunology*; D006801:Humans; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis / Q000188:drug therapy / Q000276:immunology*; D012859:Sjogren's Syndrome / Q000150:complications* / Q000276:immunology / Q000503:physiopathology; D016896:Treatment Outcome
D000893:Anti-Inflammatory Agents; D000974:Antibodies, Antinuclear; C035356:SS-A antibodies; D003907:Dexamethasone