新生儿红斑狼疮4例临床分析并文献复习

发布时间：2018-04-28 05:36

本文选题：新生儿 + 红斑狼疮　；参考：《中国皮肤性病学杂志》2017年07期

【摘要】：目的探讨新生儿红斑狼疮(neonatal lupus erythematosus,NLE)临床特点、治疗及预后。方法回顾性分析本科诊治的4例新生儿红斑狼疮临床资料,并复习相关文献。结果男女各2例,皮损均主要位于头面及躯干,无心脏传导阻滞,仅1例心脏B超示:先天性心脏病,房间隔中心型缺损(房水平左向右分流);2例有轻度至中度贫血;1例出生后10天时出现转氨酶升高及高胆红素血症。患儿和其母亲抗核抗体(antinuclear antibody,ANA)及抗干燥综合征抗原A(SSA)抗体均阳性,3例抗干燥综合征抗原B(SSB)抗体阳性;1例患儿母亲产前诊断为干燥综合征(SS),1例母亲产后1月出现亚急性皮肤型红斑狼疮(subacute cutaneous lupus erythematosus,SCLE)皮损,另1例母亲产后2年诊断系统性红斑狼疮(systemic lupus erythematosus,SLE)。结论国内NLE患儿以一过性皮肤损害为主要临床表现,可伴有轻度肝脏和血液系统损害,而先天性心脏传导阻滞(congenital heart block,CHB)较为少见。抗Ro/SSA、抗La/SSB抗体是NLE患儿及母亲最常见的抗体。本病预后较好,但需长期随访。
[Abstract]:Objective to investigate the clinical features, treatment and prognosis of neonatal lupus erythematosus. Methods the clinical data of 4 newborns with lupus erythematosus were retrospectively analyzed and the related literatures were reviewed. Results the skin lesions were mainly located on the head and trunk, and there was no cardiac block. Only one case of congenital heart disease was shown by B-mode echocardiography. Atrial septal central defect (left to right atrial shunt in 2 cases with mild to moderate anemia 1 case had elevated transaminase and hyperbilirubinemia 10 days after birth). Children and their mothers antinuclear antibody-ANA) and anti-Sjogren syndrome antigens (Agna) were both positive in 3 cases with anti-Sjogren syndrome antigen (BSA) and 1 case with mother's prenatal diagnosis of Sjogren's syndrome (Sjogren's syndrome), 1 case with Sjogren's syndrome and 1 case with subacute postpartum 1 case with Sjogren's syndrome (Sjogren's syndrome) at 1 month postpartum. Cutaneous lupus erythematosus subacute cutaneous lupus erythematosus (SCL) lesions, Another case was diagnosed as systemic lupus erythematosus lupus systemic lupus erythematosus after 2 years postpartum. Conclusion transient skin damage is the main clinical manifestation of NLE in China, which may be accompanied by mild liver and blood system damage, while congenital cardiac block heart block (CHB) is rare. Anti-Rop-SSA, anti-La/SSB antibodies are the most common antibodies in children and mothers with NLE. The prognosis of the disease is good, but long-term follow-up is needed.
【作者单位】：贵州医科大学第二附属医院皮肤科;贵州医科大学附属医院皮肤科;贵州医科大学附属医院新生儿科;
【分类号】：R722.1

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