Jiang Haiyan, Qiu Hong, Wang Minghuan, Yang Haiyin, Li Li, Li Yanhong
Neonatal Intensive Care Unit, Women and Children's Hospital of Ningbo University, Ningbo, Zhejiang, China.
Front Pediatr. 2025 Jun 12;13:1592459. doi: 10.3389/fped.2025.1592459. eCollection 2025.
Neonatal herpes simplex virus (HSV) infection complicated by neonatal lupus erythematosus (NLE) is rare and is associated with high mortality and poor neurological outcomes in survivors. Enhancing clinical understanding of this condition is essential to reduce misdiagnosis and missed diagnosis.
A neonate presented with complete atrioventricular block (CAVB) as the initial clinical manifestation, which was successfully resolved following combined therapy with isoproterenol, hydrocortisone, and intravenous immunoglobulin (IVIG). Maternal history of HSV infection during pregnancy, coupled with suspected herpetic skin lesions in the neonate, strongly suggested HSV as the putative etiology. Despite initiation of acyclovir therapy for confirmed HSV infection, the recurrence of cutaneous rash prompted further evaluation, leading to the diagnosis of NLE. Notably, no specific treatment was administered for NLE, as the condition remained clinically quiescent. Follow-up at 7 months of age revealed no neurological abnormalities, no recurrence of CAVB, and gradual resolution of the rash.
The clinical presentations of neonatal HSV infection and NLE can overlap. Early diagnosis and intervention are crucial for successful treatment and improved prognosis.
新生儿单纯疱疹病毒（HSV）感染合并新生儿红斑狼疮（NLE）较为罕见，且与高死亡率及幸存者不良神经学预后相关。增强对该病症的临床认识对于减少误诊和漏诊至关重要。
一名新生儿以完全性房室传导阻滞（CAVB）为首发临床表现，经异丙肾上腺素、氢化可的松和静脉注射免疫球蛋白（IVIG）联合治疗后成功缓解。母亲孕期有HSV感染史，加之新生儿疑似疱疹性皮肤病变，强烈提示HSV为可能病因。尽管已针对确诊的HSV感染开始使用阿昔洛韦治疗，但皮疹复发促使进一步评估，最终诊断为NLE。值得注意的是，由于NLE在临床上保持静止状态，未对其进行特殊治疗。7个月大时的随访显示无神经学异常，CAVB未复发，皮疹逐渐消退。
新生儿HSV感染和NLE的临床表现可能重叠。早期诊断和干预对于成功治疗及改善预后至关重要。
