A Broader Perspective on Anti-Ro Antibodies and Their Fetal Consequences—A Case Report and Literature Review

Autor: Mihaela Roxana Popescu, Andreea Dudu, Ciprian Jurcut, Anca Marina Ciobanu, Ana-Maria Zagrean, Anca Maria Panaitescu
Jazyk: angličtina
Rok vydání: 2020
Předmět:
Zdroj: Diagnostics, Vol 10, Iss 7, p 478 (2020)
Druh dokumentu: article
ISSN: 10070478
2075-4418
DOI: 10.3390/diagnostics10070478
Popis: The presence of maternal Anti-Ro/Anti-La antibodies causes a passively acquired autoimmunity that may be associated with serious fetal complications. The classic example is the autoimmune-mediated congenital heart block (CHB) which is due in most cases to the transplacental passage of Anti-Ro/Anti-La antibodies. The exact mechanisms through which these pathologic events arise are linked to disturbances in calcium channels function, impairment of calcium homeostasis and ultimately apoptosis, inflammation and fibrosis. CHB still represents a challenging diagnosis and a source of debate regarding the best management. As the third-degree block is usually irreversible, the best strategy is risk awareness and prevention. Although CHB is a rare occurrence, it affects one in 20,000 live births, with a high overall mortality rate (up to 20%, with 70% of in utero deaths). There is also concern over the lifelong consequences, as most babies need a pacemaker. This review aims to offer, apart from the data needed for a better understanding of the issue at hand, a broader perspective of the specialists directly involved in managing this pathology: the rheumatologist, the maternal–fetal specialist and the cardiologist. To better illustrate the theoretical facts presented, we also include a representative clinical case.
Databáze: Directory of Open Access Journals
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