Shah A, Winrow A, Fulljames R, Naqvi N, Bansal R A, Bansal A S
Department of Paediatrics and Immunology, Kingston Hospital, Kingston, Surrey, United Kingdom.
AJP Rep. 2013 Oct;3(2):91-6. doi: 10.1055/s-0033-1344003. Epub 2013 May 21.
Severe asymmetrical hypertrophic cardiomyopathy without heart block accompanied by neuromuscular hypotonia and feeding difficulties was evident shortly after birth in the second child of a mother with systemic lupus erythematosus who had no indication of gestational diabetes. High-level anti-ribonucleoprotein (RNP) and Smoth (Sm) antibodies arising from transplacental transfer of maternal antibodies were detected in the child's serum. The cardiac abnormalities improved with a commensurate decline in antibody titers. Previously reported cases of neonatal cardiomyopathy with endocardial fibroelastosis have been ascribed to the transplacental transfer of maternal Sjogrens Syndrome (SS) A (Ro) and Sjogrens Syndrome (SS) B (La) antibodies and have been more severe and persistent compared with our patient. We advocate close monitoring of all babies of mothers with systemic autoimmunity for changes in heart rate during pregnancy and signs of heart failure and neuromuscular weakness after delivery.
一名患有系统性红斑狼疮且无妊娠糖尿病迹象的母亲所生的第二个孩子，出生后不久即出现严重的非对称性肥厚型心肌病，无心脏传导阻滞，伴有神经肌肉张力减退和喂养困难。在孩子的血清中检测到通过胎盘转移的母体抗体产生的高水平抗核糖核蛋白（RNP）和史密斯（Sm）抗体。随着抗体滴度相应下降，心脏异常情况有所改善。先前报道的伴有心内膜弹力纤维增生症的新生儿心肌病病例归因于母体干燥综合征（SS）A（Ro）和干燥综合征（SS）B（La）抗体的胎盘转移，与我们的患者相比，病情更严重且持续时间更长。我们主张对所有患有系统性自身免疫性疾病母亲的婴儿在孕期密切监测心率变化，产后密切监测心力衰竭和神经肌肉无力的迹象。
