Second-degree atrioventricular block as an early manifestation of adult systemic lupus erythematosus

An-Ping Huo¹, Kang-Cheng Su², Hsien-Tzung Liao¹, Chung-Tei Chou¹, Hsiao-Ning Chang^1
1Section of Allergy, Immunology, and Rheumatology, Department of Medicine and ²Department of Chest Medicine, Taipei Veterans General Hospital and National Yang-Ming University School of Medicine, Taipei, Taiwan

Received: February 4, 2004 Revised: March 1, 2004 Accepted: September 15, 2004

Corresponding author: Hsiao-Ning Chang, Section of Allergy, Immunology, and Rheumatology, Department of Medicine, Taipei Veterans General Hospital, 201 Sec. 2, Shipai Road, Taipei 112, Taiwan. E-mail:

Second-degree atrioventricular (AV) block had not been reported as an early manifestation of adult systemic lupus erythematosus (SLE). An 18-year-old woman of SLE presented with asymptomatic second-degree AV block with 2:1 conduction block on electrocardiogram (ECG) during admission. Serologic tests were negative for anti-Sjgren's syndrome A (anti-SS-A/Ro) and anti-SS-B/La antibodies, but positive for anti-ribonuclearprotein antibodies. Her abnormal ECG completely resolved soon after high-dose intravenous methylprednisolone infusion, and she was maintained successfully with a low dose of oral steroid. The possible pathogenesis of this complication is discussed. Follow-up with periodical ECG is recommended for adult lupus patients to screen for possible conduction system involvement, and treatment should be started as soon as possible.

Key words: Heart block, ribonuclearprotein antigen, SS-A antibodies, systemic lupus erythematosus

J Microbiol Immunol Infect 2005;38:296-299.