루푸스 산모에서 태어난 신생아의 예후
The Clinical Characteristics and Outcome of Neonates born to Systemic Lupus Erythematosus Mothers
강현수, 송은송, 최영륜, 송태복, 마재숙,
소속 상세정보
강현수 ( Kang Hyun-Soo )
전남대학교 의과대학 소아과학교실
송은송 ( Song Eun-Song )
전남대학교 의과대학 소아과학교실
최영륜 ( Choi Young-Youn )
전남대학교 의과대학 소아과학교실
송태복 ( Song Tae-Bok )
전남대학교 의과대학 산부인과학교실
마재숙 ( Ma Jae-Sook )
전남대학교 의과대학 소아과학교실
KMID : 0438520060130010139
Abstract
Purpose:Neonatal lupus erythematosus (NLE) is a rare disorder caused by the transplacentally transmitted maternal autoantibodies. It is characterized by congenital complete atrioventricular block (CCAVB), skin lesion and less commonly hepatic and hematologic abnormalities. This study was designed to investigate the clinical characteristics and outcome of systemic lupus erythematosus (SLE) mothers and their neonates.
Methods:29 neonates born to 25 SLE mothers were admitted to the Neonatal Intensive Care Unit of Chonnam University Hospital between January 1994 and June 2005. We investigate the medical records retrospectively.
Results:Among 25 SLE mothers, 32.4% had history of spontaneous abortion or stillbirth in previous pregnancy, and 7 (28.0%) of preeclampsia and 3 (12.0%) of premature rupture of membranes in present pregnancy. Among 29 newborns, 14 (48.2%) were premature, 4 (13.7%) were intrauterine growth retardation, and 11 (37.9%) were confirmed as NLE. Anti-SSA/Ro was positive in 13 (52.0%) of 25 examined neonates including 6 (85.7%) of 7 neonates with electrocardiographic abnormalities. Two cases of CCAVB were diagnosed during the pregnancy. One patient didn’t show heart failure, he is on the followed up without medical treatment until 4 years of age. The other one showed heart failure, cardiac pacemaker was inserted at 7 days of age, dilated cardiomyopathy developed at 4 years of age. Five neonates with sinus bradycardia resolved spontaneously. One (3.4%) had typical lupus skin lesion with thrombocytopenia and elevated liver enzyme, one (3.4%) had leukopenia, and two (6.9%) had elevated liver enzymes only.
Conclusions:With careful antenatal monitoring of SLE mothers and their fetuses, neonates should be monitored by autoantibody, EKG, and laboratory test. (J Korean Soc Neonatol 2006;13:139-148)
키워드
Neonatal lupus erythematosus;Autoanibody;Complete heart block
원문 및 링크아웃 정보
등재저널 정보