Neonatal Lupus Syndrome Essay

Neonatal lupus erythematosus is an uncommon autoimmune disease which associated with the transplacental passage of maternal autoantibodies which affect atrioventricular node and hiss bundles of fetus heart and can cause fibrosis and calcification of cardiac structure(3). Fetal exposure to these maternal autoantibodies can also because myocarditis creates a late onset cardiomyopathy (8). Our patient suffered from isolated CCHB without any evidence of structural damage or myocarditis. Almost CCHB can be defined at 18-28 weeks gestational age, 6 weeks after passage of maternal IgG autoantibodies, due to fetal bradycardia and its confirmation is by using fetal echocardiography. Our baby showed bradycardia at 29 gestational ages in routine sonography …show more content…
Opposite of other manifestation of lupus erythematous syndrome, heart block is not reversible. The degree of heart block in NLE may vary from first degree to third degree block, but most cases diagnosed in utero present with a least second degree or more advanced block. Approximately two- thirds of these patients need to pace maker (1). In most of the patients with CCHB, early death is because of delayed initiation of pace maker or hemodynamic instability associated with significant congenital heart disease (10). Indications of pace maker initiation are symptomatic bradycardia or heart rate less than 55 beats/ minute without structural abnormality and less than 70 beats / minute in patients with structural damage, cardiomyopathy, and ventricular dysfunction (1). Our case did not need to pace maker in eight months close follow up. Based on autoimmune pathophysiology of NLE, dexamethasone, which is not metabolized by the placenta, is one of the treatment options. Plasmapheresis and beta mimetic agents are some others (11). In our patient lack of Mother Corporation caused no treatment in