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新生儿血小板减少症合并系统性红斑狼疮的临床与输血治疗方法:一例报告

Clinical and Transfusion Approach to Neonatal Thrombocytopenia Associated With Systemic Lupus Erythematosus: A Case Report.

作者信息

Rosado-Ordaz Alejandra G, Espadas-Sauri Paulina, Ayuso-Diaz Victor M

机构信息

Faculty of Medicine, Universidad Autónoma De Yucatán (UADY), Mérida, MEX.

Department of Pediatrics, Institute for Social Security and Services for State Workers (ISSSTE) - Hospital Regional "Elvia Carrillo Puerto", Mérida, MEX.

出版信息

Cureus. 2025 Jul 29;17(7):e88979. doi: 10.7759/cureus.88979. eCollection 2025 Jul.

Abstract

Autoimmune diseases present a clinical challenge for young women of childbearing age since pregnancy can affect their progression and lead to complications for both mother and baby. Systemic lupus erythematosus (SLE) is of particular interest in this context due to its association with an increased risk of spontaneous abortion, foetal death, pre-eclampsia, intrauterine growth restriction, preterm delivery, and various neonatal manifestations, including thrombocytopenia. In this context, autoimmune neonatal thrombocytopenia, caused by the transplacental transfer of maternal autoantibodies, may be the first sign of an undiagnosed autoimmune disease in the mother. This report documents the clinical and transfusion management of severe neonatal thrombocytopenia in a pregnancy involving a mother with a history of idiopathic thrombocytopenic purpura. Subsequent study revealed positive serology for SLE. The favourable outcome for the neonate following intensive management underscores the importance of promptly identifying this condition and adopting a multidisciplinary approach to minimise the risk of severe haemorrhagic complications.

摘要

自身免疫性疾病给育龄期年轻女性带来了临床挑战,因为怀孕会影响疾病进展,并导致母婴出现并发症。系统性红斑狼疮(SLE)在这种情况下尤其值得关注,因为它与自然流产、胎儿死亡、先兆子痫、胎儿生长受限、早产以及包括血小板减少症在内的各种新生儿表现的风险增加有关。在这种情况下,由母体自身抗体经胎盘转移引起的自身免疫性新生儿血小板减少症,可能是母亲未被诊断出的自身免疫性疾病的首个迹象。本报告记录了一名有特发性血小板减少性紫癜病史的母亲在孕期发生严重新生儿血小板减少症的临床情况及输血管理。随后的研究显示SLE血清学呈阳性。经过强化治疗后新生儿取得了良好的预后,这突出了及时识别这种情况并采用多学科方法以将严重出血并发症风险降至最低的重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9c8a/12393008/d86f16afda32/cureus-0017-00000088979-i01.jpg

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