长时间皮肤病变婴儿抗ro /SSA和抗la /SSB抗体阳性发生率及其与母亲自身免疫性疾病的关系

M. Makhlouf, Suzan Fahim Ghobashy, H. F. Mohamed, Ikram I. Alyan, Fawzy Aly Abualfadl
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Aim of the study: The aim of this study was to determine the incidence of positive anti-Ro/SSA and anti-La/SSB antibodies in infants with recurrent prolonged skin lesions and their mothers to determine asymptomatic mothers at risk to develop autoimmune disease. Subjects and methods: a total of 90 infants with recurrent prolonged skin lesions below the age of 6 months and their mothers attending pediatric screening and follow up clinic at Al Galaa Teaching Hospital in Cairo, Egypt were investigated for positivity of anti Ro/SSA and anti La/SSB antibodies using enzyme linked immunoassay (ELISA). Results: Incidence rate of positive anti Ro/SSA alone and anti La/SSB alone antibodies in infants were 34.4% and 23.3% respectively, and positive both anti Ro/SSA and anti La/SSB antibodies was 21.1%, while in their mothers, positive both anti Ro/SSA and anti La/SSB antibodies was 36.7%. Among the 33 cases with positive antibodies female: male ratio was 2.3:1, and rheumatologic and autoimmune diseases was positive in 14 (42.4%) mothers, while, 19 (57.6%) were asymptomatic mothers, anemia, lymphocytosis, neutropenia with relative lymphocytosis, eosinophilia and thrombocytopenia were found in 6.1%, 9.1%, 3.0%, 9.1% and 12.1% respectively. Liver transaminases were elevated in 4 (12.1%). Positive anti Ro/SSA and anti La/SSB antibodies were statistically significantly correlated with infant age, body weight, body length and head circumference, female sex, infants mothers’ rheumatologic and autoimmune diseases, distribution of skin lesions, positive history of steroid containing cream use, and thrombocytopenia. However, both antibodies showed no statistically significant correlation with infant feeding, rate of recurrent skin lesions, anemia, lymphocytosis, neutropenia with relative lymphocytosis, eosinophilia, positive CRP, and elevated ESR. 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引用次数: 0

摘要

许多文献报道新生儿红斑狼疮及其相关异常主要与抗ro /SSA和抗la /SSB抗体相关,主要有皮肤红斑狼疮病变、先天性心脏传导阻滞(CHB)、血液学细胞减少、肝胆疾病和心肌病。近95%的NLE婴儿出现皮肤症状,其他报道100%的CHB NLE婴儿抗Ro/SSA抗体阳性,90.2%的皮肤NLE婴儿抗Ro/SSA抗体阳性。对新生儿狼疮患儿及其未受影响的兄弟姐妹的长期随访显示,12.24%的新生儿狼疮患儿在8年后确诊为风湿病/自身免疫性疾病。研究目的:本研究的目的是确定复发性长时间皮肤病变婴儿及其母亲中抗ro /SSA和抗la /SSB抗体阳性的发生率,以确定无症状母亲是否有发生自身免疫性疾病的风险。研究对象和方法:采用酶联免疫分析法(ELISA)对在埃及开罗Al Galaa教学医院儿科筛查和随访门诊就诊的90例6个月以下复发性延长性皮肤病变婴儿及其母亲进行抗Ro/SSA和抗La/SSB抗体阳性检测。结果:婴儿中单抗Ro/SSA和单抗La/SSB抗体阳性率分别为34.4%和23.3%,单抗Ro/SSA和单抗La/SSB抗体阳性率分别为21.1%,母亲中单抗Ro/SSA和单抗La/SSB抗体阳性率分别为36.7%。33例抗体阳性女性:男性比例为2.3:1,有风湿病和自身免疫性疾病阳性14例(42.4%),无症状母亲19例(57.6%),贫血、淋巴细胞增多症、中性粒细胞减少症伴相对淋巴细胞增多症、嗜酸性粒细胞增多症和血小板减少症分别占6.1%、9.1%、3.0%、9.1%和12.1%。4例(12.1%)肝脏转氨酶升高。抗Ro/SSA和抗La/SSB抗体阳性与婴儿年龄、体重、体长和头围、女性、婴儿母亲的风湿病和自身免疫性疾病、皮肤病变分布、使用类固醇乳膏的阳性史、血小板减少症有统计学意义。然而,这两种抗体与婴儿喂养、皮肤病变复发率、贫血、淋巴细胞增多、中性粒细胞减少伴相对淋巴细胞增多、嗜酸性粒细胞增多、CRP阳性和ESR升高均无统计学意义。结论:对于长时间皮肤病变且抗Ro/SSA和抗La/SSB抗体阳性的婴儿,尤其是无症状的母亲,应及时调查和随访NLE和自身免疫性疾病的发展情况。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Incidence of Positive Anti-Ro/SSA and Anti-La/SSB Antibodies Among Infants with Prolonged Skin Lesions and Its Relation to Autoimmune Disease in the Mother
Many literatures reported that neonatal lupus erythematosus and its associated abnormalities mainly, cutaneous lupus lesions, congenital heart block (CHB), hematologic cytopenias, hepatobiliary disease and cardiomyopathy are associated with anti-Ro/SSA and anti-La/SSB antibodies. With skin findings occur in nearly 95% of NLE infants, others reported that 100% of NLE infants with CHB were positive for anti Ro/SSA antibodies and 90.2% of infants with skin NLE were positive for anti Ro/SSA. And long-term follow-up of children with neonatal lupus and their unaffected siblings revealed that 12.24% of NLE children identified definite rheumatic/autoimmune diseases after more than 8 years. Aim of the study: The aim of this study was to determine the incidence of positive anti-Ro/SSA and anti-La/SSB antibodies in infants with recurrent prolonged skin lesions and their mothers to determine asymptomatic mothers at risk to develop autoimmune disease. Subjects and methods: a total of 90 infants with recurrent prolonged skin lesions below the age of 6 months and their mothers attending pediatric screening and follow up clinic at Al Galaa Teaching Hospital in Cairo, Egypt were investigated for positivity of anti Ro/SSA and anti La/SSB antibodies using enzyme linked immunoassay (ELISA). Results: Incidence rate of positive anti Ro/SSA alone and anti La/SSB alone antibodies in infants were 34.4% and 23.3% respectively, and positive both anti Ro/SSA and anti La/SSB antibodies was 21.1%, while in their mothers, positive both anti Ro/SSA and anti La/SSB antibodies was 36.7%. Among the 33 cases with positive antibodies female: male ratio was 2.3:1, and rheumatologic and autoimmune diseases was positive in 14 (42.4%) mothers, while, 19 (57.6%) were asymptomatic mothers, anemia, lymphocytosis, neutropenia with relative lymphocytosis, eosinophilia and thrombocytopenia were found in 6.1%, 9.1%, 3.0%, 9.1% and 12.1% respectively. Liver transaminases were elevated in 4 (12.1%). Positive anti Ro/SSA and anti La/SSB antibodies were statistically significantly correlated with infant age, body weight, body length and head circumference, female sex, infants mothers’ rheumatologic and autoimmune diseases, distribution of skin lesions, positive history of steroid containing cream use, and thrombocytopenia. However, both antibodies showed no statistically significant correlation with infant feeding, rate of recurrent skin lesions, anemia, lymphocytosis, neutropenia with relative lymphocytosis, eosinophilia, positive CRP, and elevated ESR. Conclusion: our infant cases with prolonged skin lesions with positive anti Ro/SSA and anti La/SSB antibodies with their mothers’ especially asymptomatic ones should be investigated and followed up properly for development of NLE and autoimmune diseases.
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