发育医学电子杂志 Vol. 1 167-168
围产医学
病例报告
｜新生儿
早产儿红斑狼疮1例
孔祥永 叶翠 黄俊谨 封志纯
北京军区总医院附属八一儿童医院神经发育科，北京100700
One case of preterm infant with systemic lupus erythematosus
KONG Xiang-yong, YE Cui, HUANG Jun-jin, et al
摘要 患儿男，胎龄32+6周，因生后发现全身皮疹1 l 小时人院。患儿系第1胎第1产，剖宫产，出生体重 1865 g，胎膜早破13d,时，胎盘、脐带无异常。新 生JLApgar评分1、5和10分钟均评10分，因早产、 全身皮疹转入我科。入院查体：早产JLPb貌，反应 可，前囟张力不高。皮肤中等厚度，颜色红润， 全身遍布鲜红色丘疹，突出于皮肤表面，形态、 大小不等，胸背部分布密集，头面部、四肢散在 分布，见图1。呼吸平稳，双肺呼吸音粗糙，未闻 及干湿哕音。心率140次／分，律齐，各瓣膜听诊区 未闻及杂音。腹软，肝脾肋下未触及，肠鸣音存 在，四肢肌张力低下。入院后给予哌拉西林抗感 染、静脉营养支持，第2天开奶，喂养顺利，生后 第3天皮疹数量减少，第4天皮疹数量增多，直径 较前增大。血常规：白细胞总数11。7×109／L，粒 细胞0．42l，淋巴细胞0．553，血红蛋白145 g／L， 红细胞比积0．45，血小板计数52×109／L。C反应蛋白12 mg／L。血生化：白蛋白29．5 g／L，总蛋白46．5 g／L，谷丙转氨酶16 U／L，谷草转氨酶31 U／L，总胆红素22．2斗mol／L，直接胆红素13．9斗mol／L，尿素氮6．8斗mol／L，肌酐47斗mol，L，乳酸脱氢酶528 U／L，肌酸激酶同工酶30U／L，血钾4．51mmol／L，血二氧化碳结合力14．1 mmol／L。凝血功能：PT 11．2秒、APTT 30．7秒、D一二聚体2．2 mg／L。真菌D一葡聚糖检测：35 1 pg／ml；血培养未见细菌生长。Torch低危。甲状腺功能5项均正常。血遗传代谢筛查未见异常。梅毒和HIV血清学试验阴性。自身抗体血清检查：自身抗体中抗核抗体测定为1：1 280(粗颗粒型)、抗RNP／SM抗体测定为1：88，抗ss—A抗体测定为1：80。仔细询问患儿母亲病史，否认皮疹、发热、关节痛、皮肤干燥等症状，行自身抗体检查，结果抗核抗体及抗ss—A抗体均阳性。结合患儿病史、临床症状、体征及自身抗体检查结果，诊断为新生儿红斑狼疮(neonatallupus erythematosus，NLE)
关键词:
新生儿红斑狼疮 ')" href="#">新生儿红斑狼疮
早产儿
收稿日期: 2013-06-17
出版日期: 2013-07-30
发布日期: 2019-09-06
期的出版日期: 2013-07-30
引用本文:
孔祥永 叶翠 黄俊谨 封志纯. 早产儿红斑狼疮1例 [J]. 发育医学电子杂志, 2013, 1(3): 167-168.
One case of preterm infant with systemic lupus erythematosus . Journal of Developmental Medicine(Electronic Version), 2013, 1(3): 167-168.
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