MYOCARDIUM DAMAGE AND ANTI-MITOCHONDRIAL ANTIBODY (AMA): CASE REPORT OF THREE NEWBORN SIBLING
- Giulia Previtali, Italy
Abstract
Background and Aims
H.R. is 30 years old egyptian woman.
Methods
In Egypt, in 2013, her first son born at 30 weeks of gestation and died after 17 days for “heart disease” (no clinical information provided). In 2016, a daughter born at 34th week: after 9 days the little girl was transferred at Papa Giovanni XXIII hospital’s ICU due to severe respiratory failure with pancarditis and dilated cardiomyopathy. Only high titre AMA-M2 of maternal origin was found without liver alterations for both mother and daughter. The newborn girl, treated with high dose prednisone, recovered completely. In 2018 H.R. started a new pregnancy and beyond AMA-M2, she was found positive for anti Sp-100 antibodies but she showed no signs of cholangitis. At the end of that pregnancy (32 weeks) a low weight newborn girl was born: after two days the little girl showed premature ventricular contractions and repolarisation abnormalities; she was transfer at ICU for cardiac monitoring and treated also with low dose prednisone because, even in this case, she was positive for AMA-M2 and Sp-100 antibodies. She recovered completely after 15 days and showed no problems during the follow up: AMA-M2 antibodies became negative after 7 months.
Results
This case report suggests that AMA could have a role in the pathogenesis of cardiac abnormalities showed by the three siblings.
Conclusions
In literature association between AMA and autoimmune cardiomyopathy is described but only in adult patients: probably because AMA test is not performed in newborn with cardiomyopathy leading to an underestimation of AMA-associated cardiomyopathy cases.