Weng Kin TAM1, Hui Ching HSU2,4, Ming Hsiung HSIEH3,4, Jong Shiuan YEH3,4, Weng Chio TAM3,4

1Department of Psychiatry, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
2Department of Internal Medicine, Division of Rheumatology, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
3Department of Internal Medicine, Division of Cardiovascular Medicine, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
4Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan

Keywords: Anti-Ro/Sjögren’s syndrome type A antibodies; complete atrioventricular block; Sjögren’s syndrome

Abstract

A 57-year-old female patient with underlying hypertension, dyslipidemia, membranous glomerulonephritis, and Sjögren’s syndrome presented to our clinic with near-syncope and dizziness symptoms. We detected non-conducted sinus beat in 12-lead electrocardiography. An echocardiography showed that the left ventricular systolic function was preserved without a regional wall abnormality. The patient did not have symptoms of congestive heart failure or recent myocardial infarction. We observed complete atrioventricular block with longest pause of 6.2 seconds in a 24-hour Holter electrocardiography, and subsequently implanted a permanent pacemaker. Anti-Ro/Sjögren’s syndrome type A antibodies are commonly seen in Sjögren’s syndrome and associated with a neonatal complete heart block. The pathogenesis of anti-Ro/Sjögren’s syndrome type A antibodies in the conduction system of an adult heart is still uncertain. In this article, we report Sjögren’s syndrome in an adult patient with complete atrioventricular block and membranous glomerulonephritis, which may be associated with a positive titer of anti-Ro/Sjögren’s syndrome type A antibodies.

Conflict of Interest

The authors declared no conflicts of interest with respect to the authorship and/or publication of this article.

Financial Disclosure

This study was supported by 105-wf-eva-15 Wan Fang Hospital Taipei Medical University.