Abstract:

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 long-term 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 anti-nuclear antibodies and anti-U1RNP 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.

Key words: lupus erythematosus, clinical symptom, newborn