Clinical Analysis And Follow-up Of 23 Cases Of Neonatal Lupus Erythematosus

Objective:To analyze the clinical characteristics and prognosis of neonatal lupus erythematosus.Methods:The clinical data of 23 cases of neonatal lupus erythematosus were collected in Children's Hospital of Chongqing Medical University from 2016 to 2018.The general condition and clinical feature of these patients were retrospectively analyzed.Follow-up of NLE patients and their mothers is performed.Results:There were 23 infants with neonatal lupus erythematosus,including 12 males and 11 females.Cutaneous lesions were present in 23 cases.The average age of onset was 31.0 days(0~ 105d),of which 15(65.2%)cases occurred in less than 30 days,8(34.8%)cases occurred within 30~105 days.SSA antibody was found in 23 infants.3 cases had mild neutropenia,6 cases had transaminase elevation,2 cases had mild hepatosplenomegaly,4 cases had atrial septal defect,1 case had atrial septal defect and ventricular septal defect.21 cases of electrocardiogram revealed no congenital heart block.The average course of rash was 85.4days(7~195d).95.5% of infants' rashes disappeared completely within 6 months after birth,71.4% of infants' rashes left without any trace,the others' rashes left with telangiectasis,hypopigmentation or hyperpigmentation.13 infants were examined by electrocardiogram and autoantibody screening on the subsequent visits,7 infants' autoantibodies disappeared completely at their age of 1,the other 4 cases at their age of 2.Electrocardiogram revealed no congenital heart block(CHB)in 13 infants.All infants had good prognosis.16 mothers were asymptomatic prior to the pregnancy.8 mothers had some progression from asymptomatic to autoimmune symptoms after follow-up in 1~2 years,of which 2 mothers showed dry mouth,dry eyes and recurrent aphtous ulcer,4 mothers were diagnosed as systemic lupus erythematosus,2 mothers developed Sjogren's syndrome.Conclusion:Neonatal lupus erythematosus had a high rate of cutaneous lesions in China,it was important for dermatologists to diagnose this disease accurately.Most of the infants had good prognosis,however,a long-term follow-up of the NLE patients and their asymptomatic mothers was still necessary.