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Anti-Ro (SSA) and anti-La (SSB) antibodies and complete congenital heart block

Y Finkelstein1, Y Adler, L Harel

  • 1Department of Pediatrics C Schneider Children's Medical Center of Israel, Petah Tikvah, Israel.

Annales De Medecine Interne
|January 1, 1997
PubMed

Insights

Complete congenital heart block (CCHB), a severe neonatal lupus complication, results from maternal antibody transfer. Early detection and intervention are crucial for affected newborns and high-risk pregnancies.

Area of Science:

  • Immunology
  • Cardiology
  • Neonatology

Background:

  • Complete congenital heart block (CCHB) is a severe manifestation of neonatal lupus syndrome with high mortality.
  • Pathogenesis involves transplacental transfer of maternal anti-Ro (SSA) and anti-La (SSB) antibodies, causing cardiac conduction system damage.
  • These antibodies are detected in maternal sera and fetal cardiac tissues.

Purpose of the Study:

  • To summarize the understanding of CCHB pathogenesis, diagnosis, and management.
  • To highlight the role of anti-Ro (SSA) and anti-La (SSB) antibodies in CCHB development.
  • To inform clinical practice regarding monitoring and treatment of CCHB.

Main Methods:

  • Review of existing literature on CCHB, neonatal lupus, and associated autoantibodies.
  • Analysis of pathogenic mechanisms involving maternal autoantibodies.
  • Summary of diagnostic findings and therapeutic approaches.

Main Results:

  • CCHB is linked to maternal anti-Ro (SSA) and anti-La (SSB) antibodies.
  • Prenatal diagnosis necessitates careful monitoring and timely delivery.
  • Treatment options are debated, including intrauterine plasmapheresis and corticosteroids, with most infants requiring pacemakers.

Conclusions:

  • Maternal anti-Ro (SSA) and anti-La (SSB) antibodies are key in CCHB pathogenesis.
  • Management requires multidisciplinary care, including fetal monitoring and postnatal intervention.
  • Testing for these antibodies in pregnant women with SLE and affected newborns is recommended.

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