Document Detail


Pregnancy outcomes in patients with autoimmune diseases and anti-Ro/SSA antibodies.
MedLine Citation:
PMID:  20012231     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Anti-Ro/SSA antibodies are associated with neonatal lupus (congenital heart block (CHB), neonatal transient skin rash, hematological and hepatic abnormalities), but do not negatively affects other gestational outcomes, and the general outcome of these pregnancies is now good, when followed by experienced multidisciplinary teams. The prevalence of CHB, defined as an atrioventricular block diagnosed in utero, at birth, or within the neonatal period (0-27 days after birth), in the offspring of an anti-Ro/SSA-positive women is 1-2%, of neonatal lupus rash around 10-20%, while laboratory abnormalities in asymptomatic babies can be detected in up to 27% of cases. The risk of recurrence of CHB is ten times higher. Most of the mothers are asymptomatic at delivery and are identified only by the birth of an affected child. Half of these asymptomatic women develop symptoms of a rheumatic disease, most commonly arthralgias and xerophtalmia, but few develop lupus nephritis. A standard therapy for CHB is still matter of investigation, although fluorinated corticosteroids have been reported to be effective for associated cardiomyopathy. Serial echocardiograms and obstetric sonograms, performed at least every 1-2 weeks starting from the 16th week of gestational age, are recommended in anti-Ro/SSA-positive pregnant women to detect early fetal abnormalities that might be a target of preventive therapy.
Authors:
Antonio Brucato; Rolando Cimaz; Roberto Caporali; Véronique Ramoni; Jill Buyon
Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Clinical reviews in allergy & immunology     Volume:  40     ISSN:  1559-0267     ISO Abbreviation:  Clin Rev Allergy Immunol     Publication Date:  2011 Feb 
Date Detail:
Created Date:  2011-01-05     Completed Date:  2011-03-28     Revised Date:  2013-04-18    
Medline Journal Info:
Nlm Unique ID:  9504368     Medline TA:  Clin Rev Allergy Immunol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  27-41     Citation Subset:  IM    
Affiliation:
Internal Medicine, Ospedali Riuniti, Largo Barozzi, Bergamo, Italy. albrucato@ospedaliriuniti.bergamo.it
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MeSH Terms
Descriptor/Qualifier:
Antibodies, Antinuclear / immunology*
Autoimmune Diseases / epidemiology,  immunology*,  physiopathology,  therapy
Female
Heart Block / congenital,  immunology,  physiopathology,  therapy
Humans
Pregnancy
Pregnancy Complications / epidemiology,  immunology,  physiopathology,  therapy
Pregnancy Outcome*
Grant Support
ID/Acronym/Agency:
R37 AR042455/AR/NIAMS NIH HHS; R37 AR042455-19/AR/NIAMS NIH HHS; R37 AR042455-20/AR/NIAMS NIH HHS
Chemical
Reg. No./Substance:
0/Antibodies, Antinuclear; 0/SS-A antibodies
Comments/Corrections

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