Case report

Fatal cardiac arrest in an adult patient with euthyroid anti-SSA/Ro-positive connective tissue disease: a case report

Michele Adami¹ , Michele Nardin² , Enrico Morello³ , Claudio Crivellaro¹ and Christian J Wiedermann¹

¹  Department of Internal Medicine, Central Hospital of Bolzano, Lorenz-Böhler-Street 5, IT-39100 Bolzano, Italy

²  Division of Anaesthesiology and Intensive Care Medicine 2, Central Hospital of Bolzano, Lorenz-Böhler-Street 5, IT-39100 Bolzano, Italy

³  Department of Haematology, Central Hospital of Bolzano, Lorenz-Böhler-Street 5, IT-39100 Bolzano, Italy

author email corresponding author email

International Archives of Medicine 2009, 2:15doi:10.1186/1755-7682-2-15

Published:	15 May 2009

Abstract

Background

Until recently, anti-SSA/Ro antibodies were not considered pathogenic for severe heart disease in adults. Prolongation of the mean QTc interval in electrocardiograms of adult patients with anti-SSA/Ro-positive connective tissue disease has been reported and could contribute to complex arrhythmias in such patients. Furthermore, complete heart block may also be related to these autoantibodies.

Case presentation

We describe the occurrence of fatal complete heart block in a euthyroid adult patient with undifferentiated connective tissue disease and polyglandular autoimmune syndrome type 2 associated with cardiovascular autonomic dysfunction who had normal QTc interval. The patient's serum contained anti-SSA/Ro.

Conclusion

This case might indicate that, although the adult heart conduction system may be relatively resistant to the development of anti-Ro-associated complete heart block, cardiac arrest may develop and even be fatal.