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Congenital&nbsp;heart&nbsp;block&nbsp;(CHB)&nbsp;is a rare occurrence, affecting about 1-to-5%&nbsp;babies born to women with systemic lupus erythematosus (SLE) or&nbsp;Sj&ouml;gren&rsquo;s&nbsp;syndrome who have autoantibodies to the cellular proteins Ro and La.&nbsp;In a study published in&nbsp;Rheumatology, researchers conducted a&nbsp;survey&nbsp;of&nbsp;an international sample of providers to determine their current practices for the prevention, screening, and treatment of congenital heart block (CHB)&nbsp;due to these types of antibodies.&nbsp;&nbsp;<blockquote class="twitter-tweet" data-width="500" data-dnt="true">
The prevention, screening and treatment of congenital heart block from neonatal <a href="https://twitter.com/hashtag/lupus?src=hash&amp;ref_src=twsrc%5Etfw">#lupus</a> <a href="https://t.co/NfRgA8iS7G">https://t.co/NfRgA8iS7G</a> Neonatal lupus provider practices Dr Jill Buyon (<a href="https://twitter.com/jbuyonic?ref_src=twsrc%5Etfw">@jbuyonic</a>) from NYU Langone Health (<a href="https://twitter.com/nyulangone?ref_src=twsrc%5Etfw">@nyulangone</a>) Published in <a href="https://twitter.com/RheumJnl?ref_src=twsrc%5Etfw">@RheumJnl</a> <a href="https://t.co/9fzEfdm5wI">pic.twitter.com/9fzEfdm5wI</a>
&mdash; Juan Ovalles MD, PhD (@DrJuanOvalles) <a href="https://twitter.com/DrJuanOvalles/status/1041310849279897601?ref_src=twsrc%5Etfw">September 16, 2018</a>
</blockquote><script async src="https://platform.twitter.com/widgets.js" charset="utf-8"></script>the&nbsp;organizing committee of the 9th International Conference of Reproduction, Pregnancy and Rheumatic Diseases&nbsp;developed a survey, which was then sent to&nbsp;attendants of the conference and authors of recent publications or abstracts at&nbsp;the American College of Rheumatology (ACR)&nbsp;2012, 2013,&nbsp;or 2014 on rheumatic diseases and pregnancy.<blockquote class="twitter-tweet" data-width="500" data-dnt="true">
prevention, screening and treatment of congenital heart block from neonatal lupus: a survey of provider practices | Rheumatology | Oxford Academic <a href="https://t.co/xfRUziiSMU">https://t.co/xfRUziiSMU</a>
&mdash; Luis Caminal (@caminalm) <a href="https://twitter.com/caminalm/status/1033984030360985601?ref_src=twsrc%5Etfw">August 27, 2018</a>
</blockquote><script async src="https://platform.twitter.com/widgets.js" charset="utf-8"></script>According to the survey results,&nbsp;80% of 49 respondents recommended screening by serial fetal&nbsp;echocardiogram (ECHO), with most starting at week 16 (59%) and stopping at week 28 (25%), in anti-Ro/SSA positive women.&nbsp;The study results showed that&nbsp;for&nbsp;women without a prior infant with neonatal lupus, respondents recommend every other week (44%) or weekly (28%) fetal ECHOs; for women with a prior infant with neonatal lupus, 80% recommend weekly fetal ECHOs.&nbsp;Respondents were then asked&nbsp;about&nbsp;medications to treat varying degrees of CHB in a 20-week pregnant, anti-Ro and La positive SLE patient. Many respondents were consistent in their suggested treatments:&nbsp;<ul>
<li data-leveltext="&#61623;" data-font="Symbol" data-listid="3" aria-setsize="-1" data-aria-posinset="1" data-aria-level="1">For first degree, respondents recommended starting dexamethasone (53%) or HCQ (43%)&nbsp;</li>
<li data-leveltext="&#61623;" data-font="Symbol" data-listid="3" aria-setsize="-1" data-aria-posinset="2" data-aria-level="1">For second degree, respondents recommended starting dexamethasone (88%)&nbsp;</li>
</ul><ul>
<li data-leveltext="&#61623;" data-font="Symbol" data-listid="3" aria-setsize="-1" data-aria-posinset="1" data-aria-level="1">For third degree, respondents recommended starting dexamethasone (55%) or&nbsp;IVIg&nbsp;(33%)&nbsp;&ndash;&nbsp;although 27% would not start treatment&nbsp;</li>
</ul>&ldquo;Despite the absence of official guidelines, many physicians with a focus on pregnancy and rheumatic disease have developed similar patterns in the screening, prevention and treatment of CHB,&rdquo; the researchers concluded.&nbsp;Check out&nbsp;an article on&nbsp;how selective&nbsp;<a href="https://proddocwire.wpengine.com/docwire-pick/tyk2-signaling-pathways-psoriasis/">TYK2 inhibition affects psoriasis</a>.&nbsp;SOURCE:&nbsp;<a href="https://academic.oup.com/rheumatology/article-abstract/57/suppl_5/v9/5076146?redirectedFrom=fulltext">Rheumatology</a>&nbsp;

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Congenital Heart Block from Neonatal Lupus: Prevention, Screening, and Treatment

Cardiology

Congenital heart block (CHB) is a rare occurrence, affecting about 1-to-5% babies born to women with systemic lupus erythematosus (SLE) or Sjögren’s syndrome who ...