Ferrazzini G, Fasnacht M, Arbenz U, Seger R, Biedermann R, Simma B, Uehlinger J, Dangel P, Fanconi S
University Children's Hospital Zurich, Switzerland.
Intensive Care Med. 1996 May;22(5):464-6. doi: 10.1007/BF01712168.
We report a case of neonatal lupus erythematosus (NLE) with congenital heart block and severe myocardial failure, which was followed from the 25th week of gestation because of fetal bradycardia. The child was delivered at the 37th week of gestation by elective cesarean section because of echocardiographically documented heart enlargement, pericardial effusion and moderate insufficiency of the mitral and tricuspid valves. In spite of immediate pacing, intubation and supportive treatment, the newborn developed progressive heart failure. Echocardiography showed endocarditis of the mitral valve and diffuse myocarditis. The heart failure resolved under steroid treatment. Our experience supports the early use of steroids in treating myocarditis due to NLE. Intrauterine steroid treatment in the presence of fetal hydrops and congenital heart block is discussed.
我们报告一例患有先天性心脏传导阻滞和严重心肌衰竭的新生儿红斑狼疮（NLE）病例，因胎儿心动过缓，自妊娠第25周起对其进行跟踪观察。由于超声心动图显示心脏扩大、心包积液以及二尖瓣和三尖瓣中度关闭不全，该患儿在妊娠第37周时通过择期剖宫产分娩。尽管立即进行了起搏、插管和支持治疗，但新生儿仍出现进行性心力衰竭。超声心动图显示二尖瓣心内膜炎和弥漫性心肌炎。在类固醇治疗下心力衰竭得到缓解。我们的经验支持早期使用类固醇治疗NLE所致的心肌炎。本文还讨论了在存在胎儿水肿和先天性心脏传导阻滞的情况下进行宫内类固醇治疗的问题。
