Callen J P, Fowler J F, Kulick K B, Stelzer G, Smith S Z
Arthritis Rheum. 1985 Mar;28(3):271-5. doi: 10.1002/art.1780280306.
Neonatal lupus erythematosus (LE) is a syndrome that is manifested by LE skin lesions and/or congenital heart block, occurring in infants at, or shortly after, birth. The syndrome is believed to be caused by transplacental passage of an IgG antibody, usually the anti-Ro (SS-A) antibody, from the mother to the infant. Although the mother may have a connective tissue disease or may be healthy, the common characteristic is the presence of maternal circulating anti-Ro antibody. It has been believed that the HLA determinants demonstrated in children who have neonatal LE were not a factor in the expression of the syndrome. We report the occurrence of neonatal LE, manifested by photosensitivity and discoid LE skin lesions, in one fraternal twin. HLA studies of this affected twin demonstrated the presence of DR3. Anti-Ro antibody was present in the mother, but was not present in either child at 4 months post-delivery. HLA determinants may be involved in the expression of disease in neonates who have been exposed to the anti-Ro antibody. Furthermore, the presence of circulating antibodies in the unaffected twin causes us to question the assumption that the anti-Ro antibody is the causative factor for the occurrence of tissue injury in children with neonatal LE.
新生儿红斑狼疮（LE）是一种在婴儿出生时或出生后不久出现的、以LE皮肤病变和/或先天性心脏传导阻滞为表现的综合征。该综合征被认为是由一种IgG抗体（通常是抗Ro[SS - A]抗体）经胎盘从母亲传给婴儿所致。尽管母亲可能患有结缔组织病或身体健康，但共同特征是母亲循环中存在抗Ro抗体。一直以来人们认为，患新生儿LE的儿童中所显示的HLA决定簇并非该综合征表达的一个因素。我们报告了一对异卵双胞胎中的一例出现以光敏性和盘状LE皮肤病变为表现的新生儿LE。对这名患病双胞胎的HLA研究显示存在DR3。母亲体内存在抗Ro抗体，但分娩后4个月时两个孩子体内均未检测到。HLA决定簇可能参与了接触抗Ro抗体的新生儿疾病的表达。此外，未患病双胞胎体内存在循环抗体，这使我们对“抗Ro抗体是新生儿LE患儿组织损伤发生的致病因素”这一假设产生质疑。
