Outcome and treatments of children born to mothers with SLE

在95例SLE孕妇妊娠中，11%发生自然流产，12%发生宫内死亡。此外，生长迟缓发生在新生儿期。这些风险被认为与抗磷脂抗体有关，包括抗心磷脂抗体和/或狼疮抗凝剂。采用免疫印迹法对4例包括皮疹和先天性心脏传导阻滞的新生儿红斑狼疮患者和32例正常分娩患者进行60kD-SS-A、52kD-SS-A和48kD-SS-B抗原抗体检测。抗52kd - ss - a和抗48kd - ss - b抗体的频率明显高于正常分娩患者，而抗60kd - ss - a的频率不明显。过敏性疾病包括特应性皮炎和支气管哮喘的患病率在母亲SLE的儿童中较高。此外，32名儿童中有39%的血清IgE水平高于年龄匹配的健康日本儿童的正常范围。SLE母亲所生的22名5岁以上儿童中有8名抗核抗体阳性。患儿发生SLE的母SLE患者均存在HLAⅱ类等位基因DQB1^*0601。对5例有抗磷脂抗体的SLE孕妇和4例有抗52kd - ss - a和/或抗48kd - ss - b抗体的SLE孕妇分别采用硫酸葡聚糖血浆置换和双滤浆置换成功。

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.