Circulation, Vol 56, 82-90, Copyright © 1977 by American Heart Association
CM McCue, ME Mantakas, JB Tingelstad and S Ruddy
Of 22 children with congenital complete heart block (CCHB) available for
study, 14 (63.6%) were born to 11 mothers with clinical or laboratory
evidence of connective tissue disease, primarily lupus erythematosus (LE).
Seven mothers had both clinical and laboratory evidence of disease while
four had only positive laboratory studies including fluorescent antinuclear
antibody, rheumatoid factor, and depressed complement levels. In adults
with systemic LE, pathologic changes in the collagen surrounding the
conduction system have led to the fibrosis and death from heart block.
Antinuclear antibodies of the IgG class cross the placental barrier and
newborn infants have been reported with transient skin lesions of lupus.
Placental transmission of such antibodies may affect the fetal cardiac
conduction system, surrounding collagen, and myocardium, leading in some
cases to CCHB. This is probably one important etiologic factor in CCHB even
though the mother is asymptomatic during her pregnancy.
ARTICLES
Congenital heart block in newborns of mothers with connective tissue disease
This article has been cited by other articles:
 |
|
 |
|
  J.P. Buyon and R.M. Clancy Dying right to live longer: positing apoptosis as a link between maternal autoantibodies and congenital heart block Lupus, February 1, 2008; 17(2): 86 - 90. [Abstract] [PDF]
|
|
|
|
 |
|
 K. J. Jenkins, A. Correa, J. A. Feinstein, L. Botto, A. E. Britt, S. R. Daniels, M. Elixson, C. A. Warnes, and C. L. Webb Noninherited Risk Factors and Congenital Cardiovascular Defects: Current Knowledge: A Scientific Statement From the American Heart Association Council on Cardiovascular Disease in the Young: Endorsed by the American Academy of Pediatrics Circulation, June 12, 2007; 115(23): 2995 - 3014. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. P.P. Smits, M. W. Veldkamp, and A. A.M. Wilde Mechanisms of inherited cardiac conduction disease Europace, January 1, 2005; 7(2): 122 - 137. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. Tveskov, A. Skytthe, P. Arnsbo, J. W. Vaupel, M. Møller, and K. Christensen Twins with implanted pacemakers: Is there an increased mortality risk for the co-twin? A follow-up study based on the Danish Twin Registry and the Danish Pacemaker Register Europace, January 1, 2005; 7(6): 598 - 603. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R Cimaz Any increased risk of autoimmune disease? Lupus, September 1, 2004; 13(9): 736 - 739. [Abstract] [PDF]
|
|
|
|
|
|
J. P Buyon, A. Rupel, and R. M Clancy Congenital heart block: do fetal factors fuel the fire from inflammation to fibrosis? Lupus, October 1, 2003; 12(10): 731 - 734. [PDF]
|
|
|
|
|
|
A Brucato, A Jonzon, D Friedman, L D Allan, G Vignati, M Gasparini, J I Stein, S Montella, M Michaelsson, and J Buyon Proposal for a new definition of congenital complete atrioventricular block Lupus, June 1, 2003; 12(6): 427 - 435. [Abstract] [PDF]
|
|
|
|
 |
|
 L. E. Nield, E. D. Silverman, J. F. Smallhorn, G. P. Taylor, J. Brendan, M. Mullen, L. N. Benson, and L. K. Hornberger Endocardial fibroelastosis associated with maternal anti-Ro and anti-La antibodies in the absence of atrioventricular block J. Am. Coll. Cardiol., August 21, 2002; 40(4): 796 - 802. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 B Maisch and A.D Ristic Immunological basis of the cardiac conduction and rhythm disorders Eur. Heart J., May 2, 2001; 22(10): 813 - 824. [PDF]
|
|
|
|
 |
|
 M. Restivo, D. O. Kozhevnikov, and M. Boutjdir Optical mapping of activation patterns in an animal model of congenital heart block Am J Physiol Heart Circ Physiol, April 1, 2001; 280(4): H1889 - H1895. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. Bonnet, D. Martin, Pascale de Lonlay, E. Villain, P. Jouvet, D. Rabier, M. Brivet, and J.-M. Saudubray Arrhythmias and Conduction Defects as Presenting Symptoms of Fatty Acid Oxidation Disorders in Children Circulation, November 30, 1999; 100(22): 2248 - 2253. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. E. Miranda-Carus, M. Boutjdir, C.-E Tseng, F. DiDonato, E. K. L. Chan, and J. P. Buyon Induction of Antibodies Reactive with SSA/Ro-SSB/La and Development of Congenital Heart Block in a Murine Model J. Immunol., December 1, 1998; 161(11): 5886 - 5892. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. E. Miranda, C.-E Tseng, W. Rashbaum, R. L. Ochs, C. A. Casiano, F. Di Donato, E. K. L. Chan, and J. P. Buyon Accessibility of SSA/Ro and SSB/La Antigens to Maternal Autoantibodies in Apoptotic Human Fetal Cardiac Myocytes J. Immunol., November 1, 1998; 161(9): 5061 - 5069. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. Boutjdir, L. Chen, * Z.-H. Zhang, C.-E Tseng, * F. DiDonato, W. Rashbaum, A. Morris, N. El-Sherif, and J. P. Buyon Arrhythmogenicity of IgG and Anti–52-kD SSA/Ro Affinity-Purified Antibodies From Mothers of Children With Congenital Heart Block Circ. Res., March 1, 1997; 80(3): 354 - 362. [Abstract] [Full Text]
|
|
|
|
|
|
L. Lee and W. Weston Cutaneous lupus erythematosus during the neonatal and childhood periods Lupus, January 1, 1997; 6(2): 132 - 138. [Abstract] [PDF]
|
|
|
|
|
|
T. N. James, E. St. Martin, P. W. Willis III, and T. O. Lohr Apoptosis as a Possible Cause of Gradual Development of Complete Heart Block and Fatal Arrhythmias Associated With Absence of the AV Node, Sinus Node, and Internodal Pathways Circulation, April 1, 1996; 93(7): 1424 - 1438. [Abstract] [Full Text]
|
|
|
|
|
|
J. P. Buyon Review: Congenital Complete Heart Block Lupus, October 1, 1993; 2(5): 291 - 295. [PDF]
|
|
|
|
|
|
J.F. Meilof, Lm.E. Frohn-Mulder, P.A. Steward, A. Szatmari, J. Hess, C.H.A. Veldhoven, R.J.T. Smeenk, and A.J.G. Swaak Maternal Autoantibodies and Congenital Heart Block: No Evidence for the Existence of a Unique Heart Block-associated Anti-Ro/SS-A Autoantibody Profile Lupus, August 1, 1993; 2(4): 239 - 246. [Abstract] [PDF]
|
|
|
|
|
|
J.F. Meilof, I.M.E. Frohn-Mulder, P.A. Steward, A. Szatmari, J. Hess, C.H.A. Veldhoven, R.J.T. Smeenk, and A.J.G. Swaak Maternal Autoantibodies and Congenital Heart Block: No Evidence for the Existence of a Unique Heart Block-associated Anti-Ro/SS-A Autoantibody Profile Lupus, January 1, 1993; 2(1_suppl): 239 - 246. [Abstract] [PDF]
|
|
|
|
 |
|
 R. Sterba Congenital Complete Atrio-Ventricular Block Associated with Fusiform Aneurysms of the Aorta and Pulmonary Artery Clinical Pediatrics, December 1, 1990; 29(12): 697 - 697. [PDF]
|
|
|
|
 |
|
 N. Y. Olson and C. B. Lindsley Neonatal Lupus Syndrome Arch Pediatr Adolesc Med, August 1, 1987; 141(8): 908 - 910. [Abstract] [PDF]
|
|
|
|
 |
|
 A. B. McCUNE, W. L. WESTON, and L. A. LEE Maternal and Fetal Outcome in Neonatal Lupus Erythematosus Ann Intern Med, April 1, 1987; 106(4): 518 - 523. [Abstract] [PDF]
|
|
|
|
|
|
L. A. Lee and W. L. Weston New Findings in Neonatal Lupus Syndrome Arch Pediatr Adolesc Med, March 1, 1984; 138(3): 233 - 236. [Abstract] [PDF]
|
|
|
|
 |
|
 T. T. Provost Commentary: Neonatal Lupus Erythematosus Arch Dermatol, July 1, 1983; 119(7): 619 - 622. [Abstract] [PDF]
|
|
|
|
|
|
L. G. FINE, E. V. BARNETT, G. M. DANOVITCH, A. R. NISSENSON, M. E. CONOLLY, S. M. LIEB, and C. T. BARRETT Systemic Lupus Erythematosus in Pregnancy Ann Intern Med, May 1, 1981; 94(5): 667 - 677. [Abstract] [PDF]
|
|
|
|
|
|
S.C. Huang Unusual Incidence of Congenital Complete Heart Block in a Small Community Hospital Clinical Pediatrics, April 1, 1979; 18(4): 248 - 250. [PDF]
|
|
|
|
|
|
L. E. Nield, E. D. Silverman, G. P. Taylor, J. F. Smallhorn, J. B. M. Mullen, N. H. Silverman, J. P. Finley, Y. M. Law, D. G. Human, P. G. Seaward, et al. Maternal Anti-Ro and Anti-La Antibody-Associated Endocardial Fibroelastosis Circulation, February 19, 2002; 105(7): 843 - 848. [Abstract] [Full Text] [PDF]
|
|