新生儿红斑狼疮7例临床分析

Clinical analysis of 7 cases neonatal lupus erythematosus

目的探讨新生儿红斑狼疮(neonatal lupus erythematosus,NLE)的临床特点、治疗及预后。方法回顾性分析2010年8月至2014年8月住院治疗的7例NLE病例的临床表现、免疫相关血清学指标并进行随访。结果 7例NLE患儿中,男5例,女2例。6例患儿有皮肤狼疮损害,血常规异常2例,心脏损害3例;抗核抗体(antinuclear antibody,ANA)和抗干燥综合征A(sj?gren’s syndrome A,SSA)抗体阳性3例,ANA、SSA和抗干燥综合征B(sj?gren’s syndrome B,SSB)抗体均阳性者2例,抗ds-DNA抗体和n RNP抗体阳性1例,SSA阳性1例;7例患儿母亲中,4例确诊系统性红斑狼疮,1例诊断为结缔组织病,2例确诊干燥综合征;患儿皮损均在6个月内消失,予激素治疗后白细胞很快升至正常,但对Ⅲ度房室传导阻滞患儿无疗效。结论根据患儿皮损和实验室检查可诊断NLE,此病具有自限性且预后良好。

Objective To improve the understanding of the clinical characteristics, treatment and prognosis of neonatal lupus erythematosus（NLE）. Method All the NLE patients were included in this study who was hospitalized in our hospital from August 2010 to August 2014. Their clinical manifestations, serum auto-antibodies, and results of follow-up were analyzed. Result A total of 7 cases of NLE were included（5 were male newborn and 2 were female newborn）. Among them, 6 cases had skin rash, 2 cases had hematological problems, 3 cases had heart abnormality. 3 cases were positive for antinuclear antibody（ANA） and sj？gren＇s syndrome A（SSA）, 2 cases were positive for ANA and anti-SSA, sj？gren＇s syndrome B（SSB）. 1 case was positive for anti-ds DNA and n RNP. 1 case was positive for SSA. The mothers of 4 cases were diagnosed as systemic lupus erythematosus, 1 mother was diagnosed as connective tissue disease, and 2 mother were diagnosed as sj？gren＇s syndrome. Skin lesions healed within six months. After accepting glucocorticoid treatment, the leukocyte became normal soon but complete heart block in children was invalid. Conclusion The diagnosis of NLE include skin lesions and serological data. The prognosis of the disease is good.