摘要
目的 提高对新生儿红斑狼疮(NLE)的认识,避免漏诊误诊。方法 回顾性分析2015年1月至2022年4月住院治疗的NLE 19例患儿临床特点、治疗、出院转归及远期预后。结果 19例中男10例,女9例;心脏系统受累14例,血液系统损害13例,肝功能损害5例,皮肤损害4例,神经系统症状2例,单症状5例,多症状14例。18例抗SSA 或SSB抗体阳性,1例仅抗核抗体及抗U1RNP抗体阳性。母亲产前系统性红斑狼疮6例,干燥综合征2例,血小板减少1例,无病史10例。4例糖皮质激素治疗,4例人免疫球蛋白治疗,9例激素联合人免疫球蛋白,1例保肝,1例未治疗,均未安装起搏器。随访至2022年8月31日,除失访4例外,1例患白癜风,1例运动发育落后,2例仍有血小板低下,无出血表现,其余患儿与正常儿童无异。结论 NLE大部分症状经治疗或观察可缓解,无严重不良预后,少数患儿症状可持续数年,部分患儿可再发免疫性疾病,无症状孕母亦可引起NLE,且产后有发生自身免疫性疾病风险,因此需加强产检及母婴随访。
Objective To improve the understanding of neonatal lupus erythematosus(NLE)and avoid the missed diagnosis and misdiagnosis of the disease.Methods The clinical characteristics,treatment,discharge outcome and longterm prognosis of 19 children with NLE who were hospitalized from January 2015 to April 2022 were retrospectively analyzed.Results Among the 19 children,there were 10 boys and 9 girls.There were 14 cases of cardiac system involvement,13 cases of blood system damage,5 cases of liver function impairment,4 cases of skin damage,2 cases of nervous system involvement,as well as 5 cases with single symptom presentations and 14 with multiple symptom presentations.Eighteen children were positive for anti-SSA or SSB antibodies,and one case was positive only for antinuclear antibodies and anti-U 1RNP antibodies.Nine mothers had a prenatal history of disease,including systemic lupus erythematosus(6 cases),Sjogren's syndrome(2 cases),and thrombocytopenia(1 case).There were 10 mothers without medical history.Four patients were treated with glucocorticoids,4 with human immunoglobulin,9 with glucocorticoids and human immunoglobulin,1 with liver protection and 1 with no treatment.All the children did not have pacemakers installed.Follow-up until August 31,2022,4 cases were lost to follow-up,1 case had vitiligo,1 case had motor developmental retardation,2 cases still had low platelet count,but no bleeding,and the rest of the children were no different from normal children.Conclusions Most of the symptoms of NLE can be relieved by treatment or observation,and there are no serious adverse outcomes.In a few children,symptoms can last for several years,and some children may develop immune diseases again.Asymptomatic pregnant mother can also cause NLE,and there is also a risk of developing autoimmune diseases after delivery,so it is necessary to strengthen prenatal testing and maternal and infant follow-up.
作者
周美娟
李洪
汪清
ZHOU Meijuan;LI Hong;WANG Qing(Children's Hospital of Soochow University,Suzhou 215000,Jiangsu,China)
出处
《临床儿科杂志》
CAS
CSCD
北大核心
2024年第6期543-546,共4页
Journal of Clinical Pediatrics
关键词
红斑狼疮
临床症状
新生儿
lupus erythematosus
clinical symptom
newborn
