Complete heart block in a 40-year-old man with anti-SSA/Ro autoantibodies

Atrio-ventricular dissociation (AVD), including complete heart block (CHB), are far more common in the elderly. We report a rare case of CHB in a 40-year-old man, who tested positive for anti-Ro autoantibodies without systemic features. He had been suffering for giddiness over the previous two month...

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Autores principales:	Raja Ezman Raja Shariff, Chiao Wen Lim, Sazzli Kasim
Formato:	article
Lenguaje:	EN
Publicado:	SAGE Publishing 2021
Materias:	Medicine R
Acceso en línea:	https://doaj.org/article/62282aa182ce47c1bcad2cb4e9f5bcbb
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spelling	oai:doaj.org-article:62282aa182ce47c1bcad2cb4e9f5bcbb2021-12-01T02:03:47ZComplete heart block in a 40-year-old man with anti-SSA/Ro autoantibodies2010-10582059-232910.1177/2010105820978668https://doaj.org/article/62282aa182ce47c1bcad2cb4e9f5bcbb2021-12-01T00:00:00Zhttps://doi.org/10.1177/2010105820978668https://doaj.org/toc/2010-1058https://doaj.org/toc/2059-2329Atrio-ventricular dissociation (AVD), including complete heart block (CHB), are far more common in the elderly. We report a rare case of CHB in a 40-year-old man, who tested positive for anti-Ro autoantibodies without systemic features. He had been suffering for giddiness over the previous two months. On arrival, his electrocardiogram revealed high-degree AVD. Upon further history, he mentioned that his 68-year-old mother with systemic lupus erythematosus (SLE) had suffered from similar episodes, requiring a permanent pacemaker implantation. On further investigation, he tested positive for antinuclear antibodies (ANA), anti-SSA/Ro and anti-RNP antibodies. However, from history and clinical examination, he had not manifested any articular, extra-articular or extra-glandular features suspicious of rheumatological conditions. Following a failed trial of intravenous hydrocortisone, he subsequently had a permanent pacemaker implanted himself. Although difficult to ascertain whether our patient suffered from a congenital form of anti-SSA/Ro-related CHB, there is evidence to suggest delayed presentation of CHB in those with anti-SSA/Ro and neonatal lupus syndrome. Anti-SSA/Ro antibodies without systemic features can be present in 3% of the population, although this occurs more commonly in the presence of a confirm diagnosis of SLE, Sjögren’s syndrome or poly- and dermatomyositis. Despite the scarcity of evidence, a trial of steroid-based treatment was attempted prior to subjecting the young patient to a permanent pacemaker and its associated complications. To our knowledge, this is only the second case of isolated anti-SSA/Ro syndrome presenting with CHB reported in the literature.Raja Ezman Raja ShariffChiao Wen LimSazzli KasimSAGE PublishingarticleMedicineRENProceedings of Singapore Healthcare, Vol 30 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R
spellingShingle	Medicine R Raja Ezman Raja Shariff Chiao Wen Lim Sazzli Kasim Complete heart block in a 40-year-old man with anti-SSA/Ro autoantibodies
description	Atrio-ventricular dissociation (AVD), including complete heart block (CHB), are far more common in the elderly. We report a rare case of CHB in a 40-year-old man, who tested positive for anti-Ro autoantibodies without systemic features. He had been suffering for giddiness over the previous two months. On arrival, his electrocardiogram revealed high-degree AVD. Upon further history, he mentioned that his 68-year-old mother with systemic lupus erythematosus (SLE) had suffered from similar episodes, requiring a permanent pacemaker implantation. On further investigation, he tested positive for antinuclear antibodies (ANA), anti-SSA/Ro and anti-RNP antibodies. However, from history and clinical examination, he had not manifested any articular, extra-articular or extra-glandular features suspicious of rheumatological conditions. Following a failed trial of intravenous hydrocortisone, he subsequently had a permanent pacemaker implanted himself. Although difficult to ascertain whether our patient suffered from a congenital form of anti-SSA/Ro-related CHB, there is evidence to suggest delayed presentation of CHB in those with anti-SSA/Ro and neonatal lupus syndrome. Anti-SSA/Ro antibodies without systemic features can be present in 3% of the population, although this occurs more commonly in the presence of a confirm diagnosis of SLE, Sjögren’s syndrome or poly- and dermatomyositis. Despite the scarcity of evidence, a trial of steroid-based treatment was attempted prior to subjecting the young patient to a permanent pacemaker and its associated complications. To our knowledge, this is only the second case of isolated anti-SSA/Ro syndrome presenting with CHB reported in the literature.
format	article
author	Raja Ezman Raja Shariff Chiao Wen Lim Sazzli Kasim
author_facet	Raja Ezman Raja Shariff Chiao Wen Lim Sazzli Kasim
author_sort	Raja Ezman Raja Shariff
title	Complete heart block in a 40-year-old man with anti-SSA/Ro autoantibodies
title_short	Complete heart block in a 40-year-old man with anti-SSA/Ro autoantibodies
title_full	Complete heart block in a 40-year-old man with anti-SSA/Ro autoantibodies
title_fullStr	Complete heart block in a 40-year-old man with anti-SSA/Ro autoantibodies
title_full_unstemmed	Complete heart block in a 40-year-old man with anti-SSA/Ro autoantibodies
title_sort	complete heart block in a 40-year-old man with anti-ssa/ro autoantibodies
publisher	SAGE Publishing
publishDate	2021
url	https://doaj.org/article/62282aa182ce47c1bcad2cb4e9f5bcbb
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Complete heart block in a 40-year-old man with anti-SSA/Ro autoantibodies

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