Ma Jingran, Li Zhenghong, Song Hongmei, Zhang Lejia
Department of Pediatrics, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, NO.1 Shuaifuyuan, Dongcheng District, Beijing, 100730, China.
Eur J Pediatr. 2024 Jan;183(1):149-155. doi: 10.1007/s00431-023-05283-8. Epub 2023 Oct 17.
This study aims to analyze the clinical characteristics and risk factors of high-risk groups of neonatal lupus erythematosus (NLE) in term infants. High-risk groups of NLE infants whose mothers were positive for anti-SSA, anti-SSB or anti-U1RNP antibodies during pregnancy were enrolled. They were born between February 2013 and February 2020, with a gestational age not less than 37 weeks. We analyzed their clinical data from birth to 24 months after birth. A total of 105 patients in the NLE high-risk group were included. Among them, 30 patients were diagnosed with NLE (NLE group), and 75 patients were not (non-NLE group). The affected systems of the NLE group included the dermal (13.3%), hepatic (76.0%), and hematological systems (43.3%). Hepatic involvement, anemia and thrombocytopenia did not emerge until 60 days, 41 days and 22 days after birth, respectively, in some cases. Systemic involvement could be cured within 3 to 12 months after birth. The clearance time of specific autoantibodies was 12 months after birth. There was no significant difference in the clinical characteristics of babies and their mothers between the two groups, neither in the positive rate nor in the clearance time of specific autoantibodies.
After standardized prenatal health care, there is still a high risk of dermal, hepatic, or hematological system involvement for high-risk groups of NLE. There are no specific indicators for the prediction of whether babies will develop NLE. All of these patients need to be followed up closely within one year after birth.
• Neonatal lupus erythematosus (NLEs) can affect the cardiac, dermal, hepatic, and hematological systems of infants.
• After standardized prenatal health care employing good multidepartment cooperation in our center, no neonates had cardiac block in this study. However, dermal, hepatic, and hematological system involvement of NLE can still gradually appear (as long as 60 days after birth in some cases) during follow-up, and some of these conditions are serious and require timely and active intervention. No single factor has been found to predict whether offspring at high-risk of NLE whose mothers are positive for anti-SSA, SSB and/or RNP will develop NLE.
本研究旨在分析足月儿中新生儿狼疮（NLE）高危组的临床特征及危险因素。纳入母亲孕期抗SSA、抗SSB或抗U1RNP抗体阳性的NLE高危组婴儿。他们于2013年2月至2020年2月出生，孕周不少于37周。我们分析了他们从出生到出生后24个月的临床资料。NLE高危组共纳入105例患者。其中，30例被诊断为NLE（NLE组），75例未被诊断为NLE（非NLE组）。NLE组受累系统包括皮肤（13.3%）、肝脏（76.0%）和血液系统（43.3%）。在某些情况下，肝脏受累、贫血和血小板减少分别在出生后60天、41天和22天出现。全身受累在出生后3至12个月内可治愈。特异性自身抗体的清除时间为出生后12个月。两组婴儿及其母亲的临床特征在特异性自身抗体的阳性率和清除时间方面均无显著差异。
经过标准化的产前保健后，NLE高危组仍有皮肤、肝脏或血液系统受累的高风险。对于婴儿是否会发生NLE，尚无预测的特异性指标。所有这些患者在出生后一年内都需要密切随访。
• 新生儿狼疮（NLE）可影响婴儿的心脏、皮肤、肝脏和血液系统。
• 在我们中心采用良好的多部门合作进行标准化产前保健后，本研究中无新生儿发生心脏传导阻滞。然而，NLE的皮肤、肝脏和血液系统受累在随访期间仍可逐渐出现（某些情况下出生后长达60天），其中一些情况较为严重，需要及时积极干预。尚未发现单一因素可预测母亲抗SSA、SSB和/或RNP阳性的NLE高危后代是否会发生NLE。
