Case Report
Copyright ©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Aug 6, 2025; 13(22): 104283
Published online Aug 6, 2025. doi: 10.12998/wjcc.v13.i22.104283
Anti-SSA/Ro antibody-positive autoimmune myocarditis combined with complete atrioventricular block requiring implantation with a permanent pacemaker: A case report
Peng-Bo Xiao, Xi-Rui Yang
Peng-Bo Xiao, Xi-Rui Yang, Department of Rheumatology and Immunology, Shengli Oilfield Central Hospital, Dongying 257034, Shandong Province, China
Author contributions: Xiao PB and Yang XR contributed equally to this work.
Informed consent statement: Informed consent was obtained from the patient for the publication of this case report.
Conflict-of-interest statement: All authors declare no conflict of interest for this article.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
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Corresponding author: Xi-Rui Yang, Chief Physician, Department of Rheumatology and Immunology, Shengli Oilfield Central Hospital, No. 31 Jinan Road, Dongying 257034, Shandong Province, China. fsmykxpb@126.com
Received: December 24, 2024
Revised: March 28, 2025
Accepted: April 14, 2025
Published online: August 6, 2025
Processing time: 148 Days and 3.9 Hours
Abstract
BACKGROUND

Autoimmune myocarditis (AM) associated with autoimmune diseases can cause complete atrioventricular block (CAVB), but the related autoantigens and the underlying mechanisms are unclear. Anti-SSA/Ro antibodies may play an important role in this process, but cases of AM with positive anti-SSA/Ro antibodies are rare. In addition, arrhythmias, such as atrioventricular block, are very common in patients with autoimmune diseases, but severe atrioventricular block requiring permanent pacemaker implantation is extremely rare.

CASE SUMMARY

The patient in this case had AM with anti-SSA/Ro antibody positivity, which was associated with connective tissue disease, and the patient subsequently developed CAVB. After intensive immunosuppressive therapy, the antibody test results became negative, and pulmonary hypertension significantly improved. However, the outcome of permanent pacemaker implantation did not change.

CONCLUSION

In clinical practice, the awareness of adult AM associated with autoimmune diseases combined with CAVB should be strengthened in clinicians, and anti-SSA/Ro antibodies may play a role in this process. Therefore, improving the detection of antibodies and early intervention, such as active immunosuppression therapy, may be very important for improving disease prognosis. For patients who do not respond to immunosuppressive therapy, implantation of a permanent pacemaker may become an essential treatment option.

Keywords: Autoimmune myocarditis; Anti-SSA/Ro antibodies; Connective tissue disease; Permanent pacemaker; Immunosuppressant; Case report

Core Tip: Anti-SSA/Ro antibodies may affect the conduction system in adults, leading to atrioventricular block, even complete atrioventricular block (CAVB). Anti-SSA/Ro antibody-positive autoimmune myocarditis (AM) complicated with CAVB is rarely reported, and the pathogenesis is not clear. Cases requiring permanent pacemaker implantation are extremely rare. This paper reports a patient who had anti-SSA/Ro antibody-positive AM complicated with CAVB, and immunosuppressive therapy did not change the outcome of permanent pacemaker implantation.