Second-degree atrioventricular block as an early manifestation of adult systemic lupus erythematosus.
Second-degree atrioventricular (AV) block had not been reported as an early manifestation of adult systemic lupus erythematosus (SLE). An 18-year-old woman of SLE presented with asymptomatic second-degree AV block with 2:1 conduction block on electrocardiogram (ECG) during admission. Serologic tests were negative for anti-Sjögren's syndrome A (anti-SS-A/Ro) and anti-SS-B/La antibodies, but positive for anti-ribonuclearprotein antibodies. Her abnormal ECG completely resolved soon after high-dose intravenous methylprednisolone infusion, and she was maintained successfully with a low dose of oral steroid. The possible pathogenesis of this complication is discussed. Follow-up with periodical ECG is recommended for adult lupus patients to screen for possible conduction system involvement, and treatment should be started as soon as possible.
Huo
An Ping
AP
Section of Allergy, Immunology, and Rheumatology, Department of Medicine, Taipei Veterans General Hospital and National Yang-Ming University School of Medicine, Taipei, Taiwan.
Su
Kang Cheng
KC
Liao
Hsien Tzung
HT
Chou
Chung Tei
CT
Chang
Hsiao Ning
HN
D000293:Adolescent; D001324:Autoantigens / Q000276:immunology; D004562:Electrocardiography; D005260:Female; D006327:Heart Block / Q000209:etiology*; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000150:complications* / Q000276:immunology; D012261:Ribonucleoproteins / Q000097:blood; D055517:snRNP Core Proteins; D000099207:SS-A Antigen
D001324:Autoantigens; D012261:Ribonucleoproteins; D055517:snRNP Core Proteins; D000099207:SS-A Antigen