Outcome and treatments of children born to mothers with SLE

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Spontaneous abortion was found in 11% and intrauterine death was found in 12% of 95 pregnancies of maternal SLE patients. Furthermore, growth retardation occurred in the immediate neonatal period. These risks were thought to associate with antiphospholipid antibodies including anticardiolipin antibodies and/or lupus anticoagulant. Four patients with neonatal lupus erythematosus including rash and congenital heart block and 32 patients with normal delivery were tested for antibodies against 60kD-SS-A, 52kD-SS-A and 48kD-SS-B antigens using immunoblotting. The frequencies of anti-52kD-SS-A and anti-48kD-SS-B antibodies were significantly higher than those in patients with normal delivery but not the frequency of anti-60kD-SS-A.The prevalence of allergic diseases including atopic dermatitis and bronchial asthma was higher in children of maternal SLE.Furthermore, 39% among 32 children had higher levels of serum IgE than those of normal range for age-matched healthy Japanese children. Eight out of twenty-twochildren more than 5 years old born to mothers with SLE had positive antinuclear antibodies. All of the maternal SLE patients whose children developed SLE had DQB1^*0601 of HLA class II alleles. Five pregnant SLE patients with antiphospholipid antibodies and four pregnant SLE patients with anti-52kD-SS-A and/or anti-48kD-SS-B antibodies were successfully treated with dextran sulfate plasmapheresis and double filtration plasmapheresis, respectively.