PDF(Pubmed)
Abstract：
BACKGROUND: It has been reported that the complete heart block (CHB) in neonatal lupus (NL) cannot be reversed. This study reported a case of NL-CHB that was reversed by transcutaneous pacing and repeated plasmapheresis.
METHODS: A 35+ 6-week male preterm baby was transferred to the neonatal intensive care unit of the Army Medical Center in May 2020 for slight cyanosis around the lips and nose. Two days after birth, a sudden decrease in heart rate was observed during electrocardiogram (EGG) monitoring. Physical examination revealed a bluish-purple discoloration around the lips and an irregular heartbeat. EGG showed the presence of isolated P (142 bpm) and QRS (78 bpm) waves, ventricular escape beats, and a diagnosis of NL-CHB. To reverse the condition, transcutaneous pacing and five sessions of plasmapheresis were performed. At a 1.5-year follow-up, the baby exhibited well-developed cardiac structure and normal neurodevelopment.
CONCLUSIONS: Transcutaneous pacing and repeated plasmapheresis might be possible to reverse CHB in NL.
METHODS: A 35+ 6-week male preterm baby was transferred to the neonatal intensive care unit of the Army Medical Center in May 2020 for slight cyanosis around the lips and nose. Two days after birth, a sudden decrease in heart rate was observed during electrocardiogram (EGG) monitoring. Physical examination revealed a bluish-purple discoloration around the lips and an irregular heartbeat. EGG showed the presence of isolated P (142 bpm) and QRS (78 bpm) waves, ventricular escape beats, and a diagnosis of NL-CHB. To reverse the condition, transcutaneous pacing and five sessions of plasmapheresis were performed. At a 1.5-year follow-up, the baby exhibited well-developed cardiac structure and normal neurodevelopment.
CONCLUSIONS: Transcutaneous pacing and repeated plasmapheresis might be possible to reverse CHB in NL.
摘要：
背景：据报道，新生儿狼疮（NL）中的完全心脏传导阻滞（CHB）无法逆转。这项研究报告了一例NL-CHB，通过经皮起搏和重复血浆置换逆转。
方法：2020年5月，一名35+6周的男性早产婴儿因嘴唇和鼻子周围有轻微的紫癜被转移到陆军医疗中心的新生儿重症监护病房。出生后两天，在心电图(EGG)监测期间观察到心率突然下降.体格检查发现嘴唇周围有蓝紫色变色和不规则的心跳。EGG显示存在孤立的P（142bpm）和QRS（78bpm）波，心室逃逸搏动,和NL-CHB的诊断。要反转条件，进行了经皮起搏和五次血浆置换。在1.5年的随访中，婴儿表现出发育良好的心脏结构和正常的神经发育。
结论：经皮起搏和重复血浆置换可能逆转NL中的CHB。
方法：2020年5月，一名35+6周的男性早产婴儿因嘴唇和鼻子周围有轻微的紫癜被转移到陆军医疗中心的新生儿重症监护病房。出生后两天，在心电图(EGG)监测期间观察到心率突然下降.体格检查发现嘴唇周围有蓝紫色变色和不规则的心跳。EGG显示存在孤立的P（142bpm）和QRS（78bpm）波，心室逃逸搏动,和NL-CHB的诊断。要反转条件，进行了经皮起搏和五次血浆置换。在1.5年的随访中，婴儿表现出发育良好的心脏结构和正常的神经发育。
结论：经皮起搏和重复血浆置换可能逆转NL中的CHB。
