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新生儿狼疮:临床挑战。

Neonatal lupus: a clinical challenge.

机构信息

Paediatrics, Hospital Garcia de Orta EPE, Almada, Setúbal, Portugal

Paediatrics, Hospital Garcia de Orta EPE, Almada, Setúbal, Portugal.

出版信息

BMJ Case Rep. 2021 Nov 29;14(11):e246590. doi: 10.1136/bcr-2021-246590.

Abstract

Neonatal lupus is an uncommon entity. The main manifestations are cutaneous and cardiac. It is caused by transplacental passage of maternal antibodies (anti-Ro/SSA or anti-La/SSB), and the diagnosis is made by its detection in the mother or child. The authors present a case of a 4-month-old female infant, with a cutaneous eruption since she was 2 months old. She had no relevant personal or family history. Analytically she had an increase in liver enzymes. The histological aspect of the skin biopsy led to an autoimmunity study on the mother and infant, both of which had positive anti-Ro/SSA antibodies, confirming the diagnosis of neonatal lupus. Cardiological study was normal. The skin lesions resolved during the first year of life. Skin lesions are the most frequent non-cardiac clinical manifestation of neonatal lupus, and they are self-limited. When there is no family history, nor cardiac involvement, the diagnosis can be challenging.

摘要

新生儿狼疮较为罕见。主要表现为皮肤和心脏病变。由母体抗体(抗 Ro/SSA 或抗 La/SSB)经胎盘转移引起,通过在母亲或孩子中检测到抗体来诊断。作者报告了一例 4 月龄女婴,其在 2 月龄时出现皮肤疹。患儿无相关个人或家族史。分析显示肝酶升高。皮肤活检的组织学特征促使对母亲和婴儿进行自身免疫研究,结果均显示抗 Ro/SSA 抗体阳性,确诊为新生儿狼疮。心脏研究正常。皮肤病变在生命的第一年得到缓解。皮肤病变是新生儿狼疮最常见的非心脏临床表现,且具有自限性。当无家族史且无心脏受累时,诊断具有挑战性。

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Neonatal lupus: a clinical challenge.新生儿狼疮:临床挑战。
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本文引用的文献

1
Neonatal lupus erythematosus - practical guidelines.新生儿红斑狼疮——实用指南。
J Perinat Med. 2021 Jan 18;49(5):529-538. doi: 10.1515/jpm-2020-0543. Print 2021 Jun 25.
2
A Neonate With Annular Cutaneous Lesions.一名患有环形皮肤病变的新生儿。
Cureus. 2020 Jul 11;12(7):e9138. doi: 10.7759/cureus.9138.
3
Neonatal Systemic Lupus Erythematosus Syndrome: a Comprehensive Review.新生儿红斑狼疮综合征:全面综述。
Clin Rev Allergy Immunol. 2017 Dec;53(3):469-476. doi: 10.1007/s12016-017-8653-0.
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[Neonatal lupus syndrome: Literature review].[新生儿狼疮综合征:文献综述]
Rev Med Interne. 2015 Mar;36(3):159-66. doi: 10.1016/j.revmed.2014.07.013. Epub 2014 Sep 17.
8
[Neonatal lupus erythematosus].
Acta Med Port. 2007 May-Jun;20(3):229-32. Epub 2007 Jul 2.

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