Liautaud Sybille, Khan Ahmed J, Nalamasu Shireesha R, Tan Irene J, Onwuanyi Anekwe E
Division of Pulmonary and Critical Care, Department of Medicine, Mount Sinai School of Medicine, 164-04, 85th Avenue, Jamaica, NY 11432, USA.
Clin Rheumatol. 2005 Apr;24(2):162-5. doi: 10.1007/s10067-004-0995-3. Epub 2004 Oct 26.
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.
系统性红斑狼疮（SLE）是一种以自身抗体和免疫复合物产生为特征的结缔组织疾病，可累及包括心脏在内的所有器官。SLE 累及传导系统的情况较少被描述。我们报告一例 45 岁无症状 SLE 女性患者，因血小板减少症被转诊至急诊科（ED），在入院常规心电图筛查时发现有一度和二度房室传导阻滞（AVB）交替出现。与急诊室（ED）记录的心电图相比，在入院前 24 小时记录的心电图显示，从轻度一度 AVB（PR 间期 = 216 毫秒）进展为显著一度 AVB（PR 间期 = 510 毫秒），随后出现二度 AVB（莫氏 I 型 - 文氏现象）。在 28 小时内记录的传导异常经皮质类固醇治疗后得到缓解。本文还讨论了关于 SLE 中心脏传导系统破坏的文献综述。
