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Variable atrioventricular block in systemic lupus erythematosus

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Abstract

Systemic lupus erythematosus (SLE), a connective tissue disease characterized by the production of auto-antibodies and immune complexes, can affect all organs including the heart. The involvement of the conduction system in SLE has been less commonly described. We report a case of an asymptomatic 45-year-old woman with SLE referred to the emergency department (ED) for thrombocytopenia, and was found to have alternating first- and second-degree atrioventricular block (AVB) during routine electrocardiographic screening for hospital admission. Serial electrocardiograms (ECG) done in the ED when compared to those recorded 24 h prior revealed progression from mild first-degree AVB (PR interval = 216 ms) to significant first-degree AVB (PR interval = 510 ms), followed by second-degree AVB (Mobitz type I—Wenckebach phenomenon). The conduction abnormalities recorded over a 28-h period resolved with corticosteroid treatment. Review of the literature on the disruption of the cardiac conduction system in SLE is discussed.

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Abbreviations

ANA:

Antinuclear antibody

AV:

Atrioventricular

AVB:

Atrioventricular block

BBB:

Bundle branch block

CHB:

Complete heart block

CK-MB:

Creatine kinase MB fraction

dsDNA:

Double-stranded deoxyribonucleic acid

ECG:

Electrocardiogram(s)

ED:

Emergency department

La/SS-B:

Sjogren syndrome associated antigen B

RNP:

Ribonucleoprotein

Ro/SS-A:

Sjogren syndrome associated antigen A

SLE:

Systemic lupus erythematosus

Sm:

Smith antibody

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Authors and Affiliations

  1. Division of Pulmonary and Critical Care, Department of Medicine, Mount Sinai School of Medicine, 164-04, 85th Avenue, Jamaica, NY, 11432, USA

    Sybille Liautaud

  2. Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, Wayne State University School of Medicine, Detroit, MI, USA

    Ahmed J. Khan

  3. Mercy Hospital, Grayling, MI, USA

    Shireesha R. Nalamasu

  4. Division of Rheumatology, Department of Medicine, Mount Sinai School of Medicine, Queens Hospital Center, Jamaica, NY, USA

    Irene J. Tan

  5. Section of Cardiology and Clinical Research Center, Morehouse School of Medicine, Atlanta, GA, USA

    Anekwe E. Onwuanyi

Authors
  1. Sybille Liautaud
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  2. Ahmed J. Khan
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  3. Shireesha R. Nalamasu
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  4. Irene J. Tan
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  5. Anekwe E. Onwuanyi
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Correspondence to Sybille Liautaud.

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Liautaud, S., Khan, A.J., Nalamasu, S.R. et al. Variable atrioventricular block in systemic lupus erythematosus. Clin Rheumatol 24, 162–165 (2005). https://doi.org/10.1007/s10067-004-0995-3

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  • DOI: https://doi.org/10.1007/s10067-004-0995-3

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