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Ductal constriction during dexamethasone treatment in an anti-SSA-antibody-exposed fetus with signs of myocardial inflammation

  • Lauren Talemal (a1), Laura Olivieri (a1) and Anita Krishnan (a1)


This report describes the clinical course and multi-modality imaging findings in an anti-SSA-antibody-exposed fetus with suspected myocardial inflammation. Postnatal cardiac MRI – using fast acquisition, free-breathing with feed-and-swaddle technique – was used to evaluate for myocardial fibrosis/inflammation. This is the first published report, to our knowledge, of ductal constriction temporally associated with oral dexamethasone therapy in an anti-SSA-antibody-exposed fetus and of the use of this unique postnatal MRI protocol in this setting.


Corresponding author

Correspondence to: L. Talemal, Department of Cardiology, Children’s National Medical Center, 111 Michigan Avenue NW, Suite WW3-200, Washington, DC 20010, United States of America. Tel: +1 202 476 2020; Fax: +1 202 476 5700; E-mail:


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1. Tham, E, Hung, R, Myers, K, et al. Optimization of myocardial nulling in pediatric cardiac MRI. Pediatr Radiol 2012; 42: 431439.
2. Krishnan, A, Pike, J, Donofrio, MT. Prenatal evaluation and management of fetuses exposed to anti-SSA/Ro antibodies. Pediatr Cardiol 2012; 33: 12451252.
3. Krishnan, A, Arya, B, Moak, J, Donofrio, MT. Outcomes of fetal echocardiographic surveillance in anti-SSA exposed fetuses at a large fetal cardiology center. Prenat Diagn 2014; 34: 12071212.
4. Donofrio, MT, Moon-Grady, AJ, Hornberger, LK, et al. Diagnosis and treatment of fetal cardiac disease: a scientific statement from the American Heart Association. Circulation 2014; 129: 21832428.
5. Nield, L, Silverman, E, Smallhorn, J, et al. Endocardial fibroelastosis associated with maternal anti-Ro and anti-La antibodies in the absence of atrioventricular block. J Am Coll Cardiol 2002; 40: 796802.
6. Saleeb, S, Copel, J, Friedman, D, Buyon, JP. Comparison of treatment with fluorinated glucocorticoids to the natural history of autoantibody-associated congenital heart block: retrospective review of the research registry for neonatal lupus. Arthritis Rheum 1999; 42: 23352345.
7. Levy, R, Matitiau, A, Ben Arie, A, et al. Indomethacin and corticosteroids: an additive constrictive effect on the fetal ductus arteriosus. Am J Perinatol 1999; 16: 379383.
8. Takami, T, Momma, K, Imamura, S. Increased constriction of the ductus arteriosus by dexamethasone, indomethacin, and rofecoxib in fetal rats. Circulation 2005; 69: 354358.
9. Latus, H, Gummel, K, Klingel, K, et al. Focal myocardial fibrosis assessed by late gadolinium enhancement cardiovascular magnetic resonance in children and adolescents with dilated cardiomyopathy. J Cardiovasc Magn Reson 2015; 17: 34.
10. Olivieri, LJ, Cross, RR, O’Brien, KE, et al. Free-breathing motion-corrected late-gadolinium-enhancement imaging improves image quality in children. Pediatr Radiol 2016 [Epub ahead of print].



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