Abstract:
BACKGROUND:Cardiac neonatal lupus syndrome is due to anti-SSA or SSB antibodies and mainly includes congenital heart block (CHB) and dilated cardiomyopathy (DCM). Its optimal management is still debated. We report a large series of autoimmune high degree CHB. METHODS:Inclusion criteria in this retrospective study were fetuses or neonates with high-degree CHB associated with maternal anti-SSA/SSB antibodies. RESULTS:214 CHB were included: 202 detected in utero at a median term of 23 weeks' gestation (WG) [range 16 to 39 WG] and 12 neonatal cases diagnosed at a median age of 0 days [range birth to 8 days]. The 214 cases of CHB included 202 (94.4%) third-degree CHB, 8 (3.7%) second-degree CHB, and 4 (1.9%) intermittent CHB. In multivariate analysis, the factors associated with feto-neonatal deaths (15.7%) were hydrops (p<0.001; hazard ratio [HR] 12.4 [95% confidence interval (95%CI) 4.7-32.7]) and prematurity (p=0.002; HR 17.1 [95%CI 2.8-103.1]). During a median follow-up of 7 years [birth to 36 years], 148 of 187 children born alive (79.1%) had a pacemaker, 35 (18.8%, one missing data) had DCM, and 22 (11.8%) died. In multivariate analysis, factors associated with child death were in utero DCM (p=0.0157; HR 6.37 [95%CI: 1.25-32.44]), postnatal DCM (p<0.0001; HR 227.58[95%CI: 24.33-2128.46]) and pacemaker implantation (p=0.0035; HR 0.11[95%CI: 0.02-0.51]). The use of fluorinated steroids was neither associated with survival nor with regression of 2nd degree CHB. CONCLUSION:In this second largest series of CHB, we confirm some of the previous results. We were unable to find data supporting the routine use of in utero fluorinated steroids.
journal_name
Autoimmun Revjournal_title
Autoimmunity reviewsauthors
Levesque K,Morel N,Maltret A,Baron G,Masseau A,Orquevaux P,Piette JC,Barriere F,Le Bidois J,Fermont L,Fain O,Theulin A,Sassolas F,Pezard P,Amoura Z,Guettrot-Imbert G,Le Mercier D,Georgin-Lavialle S,Deligny C,Hachulldoi
10.1016/j.autrev.2015.08.005subject
Has Abstractpub_date
2015-12-01 00:00:00pages
1154-60issue
12eissn
1568-9972issn
1873-0183pii
S1568-9972(15)00180-9journal_volume
14pub_type
杂志文章,评审abstract::Studies of accuracy are often more complex to understand than clinical trials, since there can be more than one outcome and scope (screening, diagnosis, and prognosis) and because results have to be reported in more than one way, than in clinical trials (relative risk or odds ratio). Sensitivity and specificity are co...
journal_title:Autoimmunity reviews
pub_type: 杂志文章,meta分析,评审
doi:10.1016/j.autrev.2012.07.004
更新日期:2012-12-01 00:00:00
abstract::Ets transcription factors function throughout development in such varied processes as cellular proliferation, apoptosis, differentiation and migration. Many have been implicated to play important roles in hematopoiesis, vasculogenesis/angiogenesis and myogenesis. Fli1 is an Ets family member that is essential for deve...
journal_title:Autoimmunity reviews
pub_type: 杂志文章,评审
doi:10.1016/j.autrev.2005.10.005
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abstract::In Multiple Sclerosis (MS) patients, conventional magnetic resonance imaging (MRI) shows a pattern of white matter (WM) disruption but may also overlook some WM damage. Diffusion tensor MRI (DT-MRI) can provide important in-vivo information about fiber direction that is not provided by conventional MRI. The geometry o...
journal_title:Autoimmunity reviews
pub_type: 杂志文章,评审
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abstract::Systemic sclerosis (SSc) is an autoimmune disease characterized by excessive extracellular matrix (ECM) deposition in the skin and other visceral organs and it is associated with immune activation characterized by autoantibody production, release of various cytokines and T-lymphocyte activation. Several recent lines o...
journal_title:Autoimmunity reviews
pub_type: 杂志文章,评审
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journal_title:Autoimmunity reviews
pub_type: 杂志文章
doi:10.1016/j.autrev.2010.10.003
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pub_type: 杂志文章
doi:10.1016/j.autrev.2009.10.001
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journal_title:Autoimmunity reviews
pub_type: 杂志文章
doi:10.1016/j.autrev.2008.07.013
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journal_title:Autoimmunity reviews
pub_type: 临床试验,杂志文章
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journal_title:Autoimmunity reviews
pub_type: 杂志文章,评审
doi:10.1016/j.autrev.2008.04.001
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journal_title:Autoimmunity reviews
pub_type: 杂志文章,评审
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journal_title:Autoimmunity reviews
pub_type: 杂志文章,评审
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更新日期:2012-08-01 00:00:00
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journal_title:Autoimmunity reviews
pub_type: 杂志文章
doi:10.1016/j.autrev.2014.11.009
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journal_title:Autoimmunity reviews
pub_type: 杂志文章,评审
doi:10.1016/j.autrev.2009.03.011
更新日期:2009-12-01 00:00:00
abstract::Autoimmune diseases are systemic or organ-specific disorders that are the result of an attack of the immune system against the body's own tissue. Development of autoimmune disease is generally avoided by distinct mechanisms that silence adaptive self-reactive T or B cells. The innate immune system is critically involv...
journal_title:Autoimmunity reviews
pub_type: 杂志文章,评审
doi:10.1016/j.autrev.2008.12.019
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journal_title:Autoimmunity reviews
pub_type: 杂志文章,评审
doi:10.1016/j.autrev.2012.02.006
更新日期:2012-09-01 00:00:00
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journal_title:Autoimmunity reviews
pub_type: 杂志文章,评审
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journal_title:Autoimmunity reviews
pub_type: 杂志文章,评审
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journal_title:Autoimmunity reviews
pub_type: 杂志文章,评审
doi:10.1016/j.autrev.2008.07.009
更新日期:2008-12-01 00:00:00
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journal_title:Autoimmunity reviews
pub_type: 杂志文章,评审
doi:10.1016/j.autrev.2016.12.011
更新日期:2017-02-01 00:00:00
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journal_title:Autoimmunity reviews
pub_type: 杂志文章,评审
doi:10.1016/j.autrev.2018.06.001
更新日期:2018-11-01 00:00:00
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journal_title:Autoimmunity reviews
pub_type: 杂志文章,评审
doi:10.1016/j.autrev.2008.07.044
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journal_title:Autoimmunity reviews
pub_type: 杂志文章,评审
doi:10.1016/j.autrev.2017.03.012
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journal_title:Autoimmunity reviews
pub_type: 杂志文章,评审
doi:10.1016/j.autrev.2012.05.001
更新日期:2012-12-01 00:00:00
abstract::The loss of immune tolerance to self antigens leads to the development of autoimmune responses. Since self antigens are often multiple and/or their sequences may be known, one approach to restore immune tolerance uses synthetic artificial peptides that interfere or compete with self peptides in the networks of cellula...
journal_title:Autoimmunity reviews
pub_type: 杂志文章,评审
doi:10.1016/j.autrev.2010.08.017
更新日期:2010-11-01 00:00:00
abstract::In patients with systemic auto-immune inflammatory rheumatic diseases (AIIRD) like rheumatoid arthritis the prevalence of cardiovascular disease (CVD) is increased. In the pathogenesis of AIIRD and atherosclerosis many similarities can be found in the process underlying CVD. Accumulation of inflammatory cells, in part...
journal_title:Autoimmunity reviews
pub_type: 杂志文章,评审
doi:10.1016/j.autrev.2011.11.002
更新日期:2012-07-01 00:00:00
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journal_title:Autoimmunity reviews
pub_type: 杂志文章,评审
doi:10.1016/j.autrev.2008.07.002
更新日期:2008-10-01 00:00:00
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journal_title:Autoimmunity reviews
pub_type: 杂志文章,评审
doi:10.1016/j.autrev.2011.07.002
更新日期:2011-11-01 00:00:00
abstract::The pathophysiology of autoimmune diseases such as Multiple Sclerosis (MS) involves a complex interaction between genetic and environmental factors. Studies of monozygotic twins suggest a significant role for environmental factors in susceptibility to MS. Numerous studies, driven by the "Hygiene Hypothesis," have focu...
journal_title:Autoimmunity reviews
pub_type: 杂志文章,评审
doi:10.1016/j.autrev.2019.102430
更新日期:2020-01-01 00:00:00