To study clinical characteristics and long-term prognosis of neonatal lupus erythematosus (NLE).

Nine children with NLE who were admitted to the Neonatal Intensive Care Unit of the Seventh Medical Center of the Chinese PLA General Hospital from April 2011 to December 2021 were selected into this study. The medical history, laboratory examination results, electrocardiogram and color Doppler echocardiography of these 9 NLE children were analyzed retrospectively, and the children were followed up by telephone and outpatient service. The procedure followed in this study conforms to the regulations of the Ethics Committee of Chinese PLA General Hospital (Approval No.2022-192), and informed consents were obtained from the guardians of children.

①Among 9 children with NLE, 7 were boy, with a gestational age ranging from 30 to 40^{+ 2} weeks. There were 4 full-term infants, and the age of onset ranged from 1 hour to 17 days. The initial symptoms included ecchymosis, rash, and decreased platelet count (PLT). ②Electrocardiogram results showed that one child had third-degree atrioventricular block (AVB) with junctional escape rhythm. Two children had rightward deviation of the electrocardiographic axis, and one of them had high voltage in the right ventricle. ③ Color Doppler echocardiography showed that 8 cases had patent foramen ovale (PFO), 1 case had patent ductus arteriosus (PDA), 1 case had uncoordinated movement of the ventricular septum and left ventricular wall, and the left ventricular ejection fraction was 50%. ④All 9 children tested positive for anti-Sjögren′s syndrome A (SSA/Ro), and 3 of them tested positive for anti-Sjögren′s syndrome B (SSB/La) antibody. ⑤ For the 5 children with decreased PLT, intravenous infusion of gamma globulin [1.0 g/kg×(1-2) times/d] was administered, and the PLT levels returned to normal. Among them, one child had a cardiac pacemaker placed, one was diagnosed with Wiskott-Aldrich syndrome (WAS) with eczema and thrombocytopenia, and the remaining children were normal. ⑥ Among the 9 children, the maximum follow-up age was 10 years old, and the minimum was 11 months. All 9 children were re-examined at 6 months after birth, and the results suggested that their motor, intellectual, and physical development were normal.

The first symptom of NLE is rash and ecchymosis, which is easy to lead to damage of cardiac conduction system and blood system. Positive autoantibodies against SSA/Ro and/or SSB/La and SSA/Ro-52 antibody are common. Except for heart damage, the clinical manifestations of NLE are temporary and do not require immunosuppressive treatment. The overall recovery is good, but long-term follow-up is still needed.