Anti-SSA/Ro autoantibodies

We have a factor, um, [lips smack] eight that's elevated and a low vitamin D of 28.

She had normal or negative anti-double stranded DNA, anti-Smith, anti-RNP, anti-SSA, CBC, liver enzymes, and thyroid function.

On exam, she has this well-demarcated depressed plaque that's purplish-gray fading to a kind of a yellow-pink color in the surrounding areas with prominent superficial v- vessels.

It's markedly tender.

It is one of the most remarkable examples of how an autoimmune disease in the mother can affect the heart of her baby.

Women with anti-Ro, also called anti-SSA, and anti-La antibodies who may have Sjögren's syndrome, lupus, or no symptoms at all can pass these antibodies across the placenta.

In about one to two percent of their pregnancies, uh, the antibodies damage the developing conduction system of the fetal heart, causing congenital heart block, usually detected between eighteen and twenty-four weeks of pregnancy.

Once complete heart block develops, it is usually irreversible, and many of these children need a pacemaker.

Inflammatory markers, ESR and C-reactive protein help, though in lupus the C-reactive protein is often normal during a flare unless there is infection or serositis.

The anti-nuclear antibody is a sensitive screening test for lupus and other connective tissue diseases, and more specific antibodies help define the disease.

Anti-double-stranded DNA and anti-Smith for lupus with low complement levels indicating activity, rheumatoid factor and anti-CCP for rheumatoid arthritis, anticentromere, anti-SCL-70 and anti-RN A polymerase 3 for systemic sclerosis, anti-Jo-1 for myositis, anti-Ro and anti-La for Sjogren's and congenital heart block risk, and anti-phospholipid antibodies.

Third, assess the heart thoroughly.

We see that with Epstein-Barr virus.

There are proteins on the Epstein-Barr virus that mimic the anti-Ro and anti-La SSA antibodies that are seen in Sjogren's.

So can an EBV infection potentially set somebody up to have a trigger for an autoimmune phenomenon like Sjogren's afterwards? It actually can, but I think you need to be genetically predisposed.

So getting back again to Stephanie's question here, are there other triggers in our environment now that are setting off these kind of anti, you know, these, these autoimmune or inflammatory cascades? Potentially.