Ulusal Romatoloji Dergisi / Journal of Turkish Society for Rheumatology
p-ISSN: 2651-2653
e-ISSN: 2651-2661
Haner Direskeneli
2019 Volume 11
Deomed Yayıncılık
Volume 11, Issue 1, June 2019
Page(s): 10-15
Clinical Research Article
Received: June 7, 2018; Accepted: August 5, 2018; Published online: June 10, 2019
doi:10.2399/raed.19.43534; Copyright © 2019 Turkish Society for Rheumatology
Wide heterogeneity in treatment protocols and inappropiate use of prednisolone for anti-Ro/La associated-congenital heart block: a systematic review of 492 cases
Abdulsamet Erden1 (E-mail), Levent Kılıç1, Alper Sarı1, Berkan Armağan1, Emre Bilgin1, Serdar Ceylan2, Yusuf Ziya Şener3, Benazir Hymabaccus2, Fatih Gürler4, Ömer Karadağ1, Umut Kalyoncu1
1Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Hacettepe University, Ankara, Turkey; 2Department of Internal Medicine, Faculty of Medicine, Hacettepe University, Ankara, Turkey; 3Department of Cardiology, Faculty of Medicine, Hacettepe University, Ankara, Turkey; 4Department of Medical Oncology, Faculty of Medicine, Gazi University, Ankara, Turkey
Objective: Neonatal lupus erythematosus is an acquired autoimmune disease which is characterised by transplacental transition of anti- SS-A/Ro and anti-SS-B/La antibodies and binding of these antibodies to fetal tissues. Cutaneous, cardiac, hepatic and hematological manifestations can be seen. Most important and serious complication is congenital heart block and this situation is a major cause of mortality approximately in 20-30% of all patients. Effectivity of current theurepatic approaches are still a questionmark. Aim of this study is to review current literature systematically to compare different treatment options.

Methods: Pubmed Medline database was literature review in August 2015. Relevant publications were seeked using the MeSH terms "neonatal lupus" and "congenital heart block"; results were restricted to studies in humans and articles in the English language. After recruiting all eligable publications, when available, treatment protocols of with congenital heart block were noted case-by-case.

Results: Treatment protocols of 243 (49.3%) over 492 patients were noted. Major drug classes and their percentage of use are as follow: Steroids in 106 (43.6%) patients, intravenous immunoglobulin in 14 (5.7%) patients and hydroxychloroquine in 5 (2%) patients. 134 (55.1%) patients had no treatment. Type of steroid was known of 92 (86.7%) patients and it was dexamethasone, prednisolon and betamethasone in 54 (58.6%), 27 (29.3%), 11 (11.9%) patients, respectively.

Conclusion: There is no pre-defined, accepted treatment regimen of congenital heart block. There is a large spectrum of treatment options and dosage of these options. Another question is that approxiamately half of the patients do not take any medication related to congenital heart block. Also another important point is that even prednisolon can not across the placental membrane, prednisolon was found to be used very common.
Keywords: Neonatal lupus, steroid, treatment, congenital heart block
RAED Dergisi / RAED Journal

Türkiye Romatoloji Derneği (TRD) yayın organıdır. Deomed Yayıncılık tarafından yayımlanmaktadır. / Official Publication of the Rheumatology Society of Turkey (TRD). Published by Deomed Publishing. Copyright © 2020, TRD.
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RAED Dergisi çevrimiçi (online) sürümünde yayımlanan akademik içeriğin kullanım hakları, ilgili içerikte tersi belirtilmediği sürece Deomed Yayıncılık tarafından Creative Commons Attribution-NoCommercial-NoDerivs 3.0 Unported (CC BY-NC-ND3.0) lisansı aracılığıyla bedelsiz sunulmaktadır. / Except where otherwise noted, academic content of this online version of the journal by Deomed Publishing is licensed under the terms of Creative Commons Attribution-NoCommercial-NoDerivs 3.0 Unported (CC BY-NC-ND3.0) License.