Autommunity and pregnancy - Autoantibodies and pregnancy in rheumatic diseases
Autommunity and pregnancy - Autoantibodies and pregnancy in rheumatic diseases
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DOI：
10.1196/annals.1351.032
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发表时间：
2006-01-01
期刊：
影响因子：
--
通讯作者：
Faden, David
中科院分区：
文献类型：
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作者：
Tincani, Angela;Nuzzo, Monica;Faden, David
在患有风湿病(RDS)的妇女中，反复胎儿丧失、胎儿宫内发育受限和早产的风险仍然高于普通人群。抗磷脂抗体常见于系统性红斑狼疮(SLE)患者。它们与任何怀孕年龄都可能发生的反复妊娠损失有关。胎儿死亡的原因被认为是胎盘内血栓形成，尽管已经描述了其他病理机制。最近的一项研究描述了SLE患者后代学习障碍的频率增加；新生儿血栓形成的病例报告非常罕见。经胎盘途径的抗Ro/SS-A抗体与新生儿狼疮有关(2%)。主要表现为先天性心脏传导阻滞(CHB)，这是由于抗Ro/SS-A抗体与心脏传导组织结合而引起的炎症/纤维瘤反应。新生儿狼疮还包括皮肤、血液和肝胆表现，这些通常是一过性的。不完全性慢性乙肝可以用氟化皮质激素治疗，以防止病情进展和减轻炎症。静脉注射免疫球蛋白，减少抗Ro/SS-A的胎盘途径，已被建议作为预防治疗有一个或多个孩子的CHB。在大约10%的SLE母亲中，抗血小板抗体经胎盘途径可导致胎儿或新生儿的血小板减少。与一般人群相比，RD患者焦虑和抑郁的发生率更高，这干扰了父母的养育和孩子的养育。
In women who suffer from rheumatic diseases (RDs) the risk of repeated fetal loss, intrauterine growth restriction, and preterm birth remains higher than in the general population. Antiphospholipid antibodies are frequently observed in patients with systemic lupus erythematosus (SLE). They are associated with recurrent pregnancy losses that may occur at any age of gestation. The cause of fetal death is believed to be intraplacental thrombosis, although other pathologic mechanisms have been described. A recent study has described the increased frequency of learning disabilities in the offspring of SLE patients; case reports of neonatal thrombosis are very rare. Transplacental passage of IgG anti-Ro/SS-A antibodies is linked to neonatal lupus (2%). The main manifestation is congenital heart block (CHB) due to the binding of anti-Ro/SS-A antibodies to cardiac conduction tissue and to the consequent inflammatory/fibroid reaction. Neonatal lupus also includes cutaneous, hematologic, and hepatobiliary manifestations, which are typically transient. Incomplete CHB can be treated with fluorinated corticosteroids to prevent the progression and decrease inflammation. Intravenous immunoglobulin, decreasing the tranplacental passage of anti-Ro/SS-A, has been proposed as prophylactic therapy in patients who had one or more child with CHB. Transplacental passage of antiplatelet antibodies, in about 10% of mothers with SLE, can induce thrombocytopenia in the fetus or the neonate. Patients with RD have a higher incidence of anxiety and depression compared to the general population, interfering with parenthood and the upbringing of children.