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  1. Article: Budd-Chiari syndrome, systemic lupus erythematosus, and secondary antiphospholipid antibody syndrome in pregnancy.

    Joffe, Gary M / Aisenbrey, Gary A / Argubright, Kent F

    Obstetrics and gynecology

    2005  Volume 106, Issue 5 Pt 2, Page(s) 1191–1194

    Abstract: Background: Hypercoaguable states such as the antiphospholipid antibody syndrome may be associated with thromboses in any vascular bed.: Case: This case report demonstrates clinical manifestations of Budd-Chiari syndrome during pregnancy, diagnostic ... ...

    Abstract Background: Hypercoaguable states such as the antiphospholipid antibody syndrome may be associated with thromboses in any vascular bed.
    Case: This case report demonstrates clinical manifestations of Budd-Chiari syndrome during pregnancy, diagnostic dilemmas, and suggestions for prevention of serious thromboembolic complications.
    Conclusion: Patients with antiphospholipid antibody syndrome and previous thromboses in any vascular bed who are considering pregnancy should be considered candidates for full anticoagulation throughout the entirety of gestation and the puerperium. Anti-Xa levels may reflect inadequate dosing of low molecular weight heparin, particularly during the first trimester, and should be monitored frequently. In patients with suspected hepatic venous thrombosis, Doppler evaluation may be inadequate to establish the diagnosis.
    MeSH term(s) Adult ; Antibodies, Antiphospholipid/blood ; Antiphospholipid Syndrome/complications ; Antiphospholipid Syndrome/etiology ; Antiphospholipid Syndrome/immunology ; Budd-Chiari Syndrome/complications ; Budd-Chiari Syndrome/diagnosis ; Budd-Chiari Syndrome/drug therapy ; Cholecystectomy, Laparoscopic ; Combined Modality Therapy ; Enoxaparin/therapeutic use ; Female ; Fibrinolytic Agents/therapeutic use ; Humans ; Liver/enzymology ; Liver/pathology ; Liver Function Tests ; Lupus Erythematosus, Systemic/complications ; Pregnancy ; Pregnancy Complications, Cardiovascular/diagnosis ; Pregnancy Complications, Cardiovascular/drug therapy ; Pregnancy Complications, Cardiovascular/surgery ; Pregnancy Outcome
    Chemical Substances Antibodies, Antiphospholipid ; Enoxaparin ; Fibrinolytic Agents
    Language English
    Publishing date 2005-11
    Publishing country United States
    Document type Case Reports ; Journal Article
    ZDB-ID 207330-4
    ISSN 1873-233X ; 0029-7844
    ISSN (online) 1873-233X
    ISSN 0029-7844
    DOI 10.1097/01.AOG.0000164067.19282.8a
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Prospective Evaluation of High Titer Autoantibodies and Fetal Home Monitoring in the Detection of Atrioventricular Block Among Anti-SSA/Ro Pregnancies.

    Buyon, Jill P / Masson, Mala / Izmirly, Caroline G / Phoon, Colin / Acherman, Ruben / Sinkovskaya, Elena / Abuhamad, Alfred / Makhoul, Majd / Satou, Gary / Hogan, Whitnee / Pinto, Nelangi / Moon-Grady, Anita / Howley, Lisa / Donofrio, Mary / Krishnan, Anita / Ahmadzia, Homa / Levasseur, Stephanie / Paul, Erin / Owens, Sonal /
    Cumbermack, Kristopher / Matta, Jyothi / Joffe, Gary / Lindblade, Christopher / Haxel, Caitlin / Kohari, Katherine / Copel, Joshua / Strainic, James / Doan, Tam / Bermudez-Wagner, Karla / Holloman, Conisha / Sheth, Shreya S / Killen, Stacy / Tacy, Theresa / Kaplinski, Michelle / Hornberger, Lisa / Carlucci, Philip M / Izmirly, Peter / Fraser, Nicola / Clancy, Robert M / Cuneo, Bettina F

    Arthritis & rheumatology (Hoboken, N.J.)

    2023  Volume 76, Issue 3, Page(s) 411–420

    Abstract: Objective: This prospective study of pregnant patients, Surveillance To Prevent AV Block Likely to Occur Quickly (STOP BLOQ), addresses the impact of anti-SSA/Ro titers and utility of ambulatory monitoring in the detection of fetal second-degree ... ...

    Abstract Objective: This prospective study of pregnant patients, Surveillance To Prevent AV Block Likely to Occur Quickly (STOP BLOQ), addresses the impact of anti-SSA/Ro titers and utility of ambulatory monitoring in the detection of fetal second-degree atrioventricular block (AVB).
    Methods: Women with anti-SSA/Ro autoantibodies by commercial testing were stratified into high and low anti-52-kD and/or 60-kD SSA/Ro titers applying at-risk thresholds defined by previous evaluation of AVB pregnancies. The high-titer group performed fetal heart rate and rhythm monitoring (FHRM) thrice daily and weekly/biweekly echocardiography from 17-26 weeks. Abnormal FHRM prompted urgent echocardiography to identify AVB.
    Results: Anti-52-kD and/or 60-kD SSA/Ro met thresholds for monitoring in 261 of 413 participants (63%); for those, AVB frequency was 3.8%. No cases occurred with low titers. The incidence of AVB increased with higher levels, reaching 7.7% for those in the top quartile for anti-60-kD SSA/Ro, which increased to 27.3% in those with a previous child who had AVB. Based on levels from 15 participants with paired samples from both an AVB and a non-AVB pregnancy, healthy pregnancies were not explained by decreased titers. FHRM was considered abnormal in 45 of 30,920 recordings, 10 confirmed AVB by urgent echocardiogram, 7 being second-degree AVB, all <12 hours from normal FHRM and within another 0.75 to 4 hours to echocardiogram. The one participant with second/third-degree and two participants with third-degree AVB were diagnosed by urgent echocardiogram >17 to 72 hours from an FHRM. Surveillance echocardiograms detected no AVB when the preceding interval FHRM recordings were normal.
    Conclusion: High-titer antibodies are associated with an increased incidence of AVB. Anti-SSA/Ro titers remain stable over time and do not explain the discordant recurrence rates, suggesting that other factors are required. Fetal heart rate and rhythm (FHRM) with results confirmed by a pediatric cardiologist reliably detects conduction abnormalities, which may reduce the need for serial echocardiograms.
    MeSH term(s) Child ; Pregnancy ; Humans ; Female ; Atrioventricular Block/diagnosis ; Atrioventricular Block/epidemiology ; Autoantibodies ; Prospective Studies ; Antibodies, Antinuclear ; Pregnancy Complications ; Echocardiography/methods
    Chemical Substances Autoantibodies ; Antibodies, Antinuclear
    Language English
    Publishing date 2023-11-10
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2756371-6
    ISSN 2326-5205 ; 2326-5191
    ISSN (online) 2326-5205
    ISSN 2326-5191
    DOI 10.1002/art.42733
    Database MEDical Literature Analysis and Retrieval System OnLINE

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