Kanda Kenji, Sato Aya, Abe Daisuke, Nishijima Setsuko, Ishigami Tsuyoshi
Department of Pediatrics, Hikone Municipal Hospital, Hikone, Shiga, Japan.
Department of Pediatrics, Hikone Municipal Hospital, Hikone, Shiga, Japan.
Pediatr Neurol. 2016 Sep;62:47-50. doi: 10.1016/j.pediatrneurol.2016.06.005. Epub 2016 Jun 15.
Neonatal cerebral infarction is a relatively common cause of neonatal seizures, with an incidence of at least 1:4000 live births and is associated with a high incidence of neurological sequelae. However, the pathophysiological mechanisms and predisposing factors responsible for neonatal infarction are not fully established.
A full-term baby boy was transferred at two days of age for the treatment of a cluster of seizures. Cranial magnetic resonance imaging revealed multiple lesions compatible with acute cerebral infarction. The results of the blood tests performed to screen for thrombophilic diseases were normal for his age, and his perinatal history was unremarkable. A diagnosis of idiopathic cerebral infarction was made. Additional examination for autoimmune diseases showed that both the mother and the patient had the anti-SS-A/Ro antibody. The patient was treated with phenobarbital and has no neurological sequelae.
This is the first report demonstrating the coexistence of neonatal cerebral infarction and neonatal lupus syndrome. Thus neonatal lupus syndrome may be an additional risk factor for neonatal stroke.
新生儿脑梗死是新生儿惊厥相对常见的病因,活产儿发病率至少为1:4000,且与神经后遗症的高发病率相关。然而,导致新生儿梗死的病理生理机制和易感因素尚未完全明确。
一名足月男婴在出生两天时因一系列惊厥发作被转诊治疗。头颅磁共振成像显示多个符合急性脑梗死的病灶。为筛查易栓症进行的血液检查结果在其年龄组中正常,围产期病史无异常。诊断为特发性脑梗死。自身免疫性疾病的进一步检查显示母亲和患儿均有抗SS-A/Ro抗体。患儿接受苯巴比妥治疗,无神经后遗症。
这是首份证明新生儿脑梗死与新生儿狼疮综合征并存的报告。因此,新生儿狼疮综合征可能是新生儿卒中的另一个危险因素。