Abstract
Trifascicular block (TFB) is rare in newborn infants. Unlike congenital complete heart block, TFB has not been previously reported in infants of mothers with lupus erythematosus. We report a newborn male (birth weight 3.2kg) born by emergency caesarean section for fetal bradycardia. Maternal past history was unremarkable. Only during the last month of her pregnancy did she take Hydralazine 10mg QID daily for hypertension. At birth, the baby had a heart rate of 60 per minute and was given Atropine without response, but improved with Isoproterenol. With the exception of bradycardia of 68 per minute, physical findings were normal. Initial electrocardiogram disclosed trifascicular block and 2:1 second degree atrioventricular block. The next day his rhythm changed to sinus rhythm and bifascicular block which have remained throughout his life. He is now 17 months old and is completely asymptomatic. Viral cultures were negative. First antinuclear antibody titers (ANA) were positive ≥ 1:640 in both mother and baby. SSA and SSB titers were negative in both. At 6 months of age ANA titer became negative in the baby. However, a persistent maternal ANA titer of ≥ 1:640 at 16 months postpartum with mild arthralgias suggests continuing evidence of systemic lupus erythematosus.
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Park, J., Agarwal, I., Contreras, E. et al. TRIFASCICULAR BLOCK IN NEONATE OF MOTHER WITH LUPUS ERYTHEMATOSUS. Pediatr Res 21 (Suppl 4), 192 (1987). https://doi.org/10.1203/00006450-198704010-00157
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DOI: https://doi.org/10.1203/00006450-198704010-00157