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Alhatemi AQM, Al-Yacopy AA, Hashim HT, Abdulhussain RK. Neonatal lupus with complete heart block and long term follow up. Oxf Med Case Reports 2024; 2024:omae056. [PMID: 38860016 PMCID: PMC11162586 DOI: 10.1093/omcr/omae056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Revised: 03/27/2024] [Accepted: 04/16/2024] [Indexed: 06/12/2024] Open
Abstract
We present the case of a 27-year-old pregnant woman, newly diagnosed with Systemic Lupus Erythematosus (SLE) during pregnancy. The patient delivered a newborn at 38 weeks gestation, who, on the first day of life, manifested complete heart block. This case underscores the clinical challenges associated with neonatal lupus, emphasizing the need for collaborative, multidisciplinary management.
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2
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Xia Q, Gu M, Xu Y, Sang H, Lin W, Wang Y, Liu K. Unmasking the invisible enemy: A case report of metagenomics-guided diagnosis and treatment of neonatal septic meningitis caused by Corynebacterium aurimucosum in a preterm infant with neonatal lupus erythematosus. Medicine (Baltimore) 2024; 103:e35968. [PMID: 38363904 PMCID: PMC10869058 DOI: 10.1097/md.0000000000035968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 10/16/2023] [Indexed: 02/18/2024] Open
Abstract
RATIONALE Neonatal septic meningitis is a serious condition that can be caused by various pathogens, including Corynebacterium aurimucosum, a rare and opportunistic bacterium. We reports a case of infectious meningitis in a premature infant with neonatal lupus erythematosus caused by C aurimucosum. The purpose of this study is to explore the occurrence of meningitis caused by C aurimucosum in preterm infants with neonatal lupus erythematosus. We found that early diagnosis and treatment are crucial for this type of meningitis, especially for infants with impaired immunity or mothers receiving immunosuppressive therapy. This bacterium is rare in clinical practice, but it needs to be taken seriously. PATIENT CONCERNS The infant was born to a mother with systemic lupus erythematosus who had a history of long-term immunosuppressive therapy. The infant presented with preterm birth, purplish-red skin, fever, and widespread scarlet dermatitis. He also had positive anti-Ro/SSA and anti-La/SSB antibodies. DIAGNOSIS The infant was diagnosed with neonatal lupus erythematosus based on clinical and serological features. A lumbar puncture revealed septic meningitis with high levels of total nucleated cells, protein, and Pan's test in the CSF. The macrogenic examination identified C aurimucosum as the causative agent. The culture of the mother's vaginal secretion also revealed the same bacterium. INTERVENTIONS The infant was treated with anti-infective therapy with ceftriaxone, ampicillin, vancomycin, and meropenem. He also received prednisone and gammaglobulin infusion for neonatal lupus erythematosus. OUTCOMES The infant's temperature returned to normal, and his general condition and responsiveness improved. The CSF cytology and biochemistry normalized, and the culture was negative. The cranial MRI examination showed no abnormalities. The red rash disappeared, and the follow-ups after discharge revealed no complications. LESSONS This case highlights the importance of early diagnosis and treatment of neonatal septic meningitis caused by C aurimucosum, especially in infants with immunocompromised conditions or maternal history of immunosuppressive therapy. C aurimucosum should not be overlooked as a potential pathogen in neonatal septic meningitis.
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Affiliation(s)
- Qing Xia
- Kunming Children’s Hospital, Pulmonary and Critical Care Medicine, Kunming, China
- The Affiliated Hospital of Kunming University of Science and Technology, The First People’s Hospital of Yunnan Province, Kunming, PR China
| | - Meiqun Gu
- The Affiliated Hospital of Kunming University of Science and Technology, The First People’s Hospital of Yunnan Province, Kunming, PR China
| | - Yu Xu
- The Affiliated Hospital of Kunming University of Science and Technology, The First People’s Hospital of Yunnan Province, Kunming, PR China
| | - Haoke Sang
- The Affiliated Hospital of Kunming University of Science and Technology, The First People’s Hospital of Yunnan Province, Kunming, PR China
| | - Wenhua Lin
- Chinese People’s Liberation Army Logistic Support Army No. 920 Hospital, Kunming, China
| | - Yajun Wang
- The Affiliated Hospital of Kunming University of Science and Technology, The First People’s Hospital of Yunnan Province, Kunming, PR China
| | - Kai Liu
- Kunming Children’s Hospital, Pulmonary and Critical Care Medicine, Kunming, China
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3
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Barreto Mota R, Santos NR, Éden P, Rodrigues M, Brito I, Soares H. Lupus Pneumonitis: Case Report of a Rare Manifestation of Neonatal Lupus. J Investig Med High Impact Case Rep 2022; 10:23247096221077815. [PMID: 35389295 PMCID: PMC9016583 DOI: 10.1177/23247096221077815] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Neonatal lupus is a rare entity, secondary to placental transfer of antibodies from
mothers with immune-mediated conditions. While pulmonary involvement is common in lupus,
its incidence in neonates is extremely rare, with very few cases being reported in the
literature. The authors report a case of a neonate whose mother was diagnosed with
systemic lupus erythematosus, with a prenatal diagnosis of third-degree atrioventricular
block. While initially admitted in the neonatal intensive care unit with no need for organ
support, he presented progressive respiratory failure, initially attributed to sepsis.
Favorable clinical progression after pacemaker placement allowed ventilatory weaning, but
respiratory failure was again apparent. Chest computer tomography revealed areas of
ground-glass lesions, raising the suspicion for lupus pneumonitis. He was started on
immunoglobulin and corticosteroids, with clinical improvement. The authors consider this
case to be relevant due to the rarity of acute lupus pneumonitis in neonates, alerting
that it must be considered a differential diagnosis in neonates with prolonged ventilator
dependency.
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Affiliation(s)
- Ricardo Barreto Mota
- Neonatology Department, Centro Hospitalar Universitário de São João, Porto, Portugal
| | - Nuno Rodrigues Santos
- Neonatology Department, Centro Hospitalar Universitário de São João, Porto, Portugal
| | - Paulo Éden
- Pediatric Cardiology Department, Centro Hospitalar Universitário São João, Porto, Portugal
| | - Mariana Rodrigues
- Pediatric and Young Adult Rheumatology Unit, Pediatrics Department, Centro Hospitalar Universitário São João, Porto, Portugal.,Department of Obstetrics-Gynecology and Pediatrics, Faculty of Medicine, University of Porto, Portugal
| | - Iva Brito
- Pediatric and Young Adult Rheumatology Unit, Pediatrics Department, Centro Hospitalar Universitário São João, Porto, Portugal.,Department of Rheumatology, Faculty of Medicine, University of Porto, Portugal
| | - Henrique Soares
- Neonatology Department, Centro Hospitalar Universitário de São João, Porto, Portugal.,Department of Obstetrics-Gynecology and Pediatrics, Faculty of Medicine, University of Porto, Portugal
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Drohan A, Snyder A, Plante J, Karlin S, Wine Lee L, Cotton CH. Neonatal lupus erythematosus presenting as orolabial ulcerations: Two cases and a review of the literature. Pediatr Dermatol 2021; 38:643-646. [PMID: 33675085 DOI: 10.1111/pde.14555] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
We report two unrelated infants who presented with orolabial ulcerations as a presenting manifestation of neonatal lupus erythematosus (NLE). Subsequent positive anti-SSA/SSB titers confirmed the diagnosis. In both infants, the ulcerations were painless and spontaneously resolved. NLE should be included in the differential diagnosis of orolabial ulcerations in the newborn, especially since mothers of affected infants may be asymptomatic.
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Affiliation(s)
- Alex Drohan
- College of Medicine, Medical University of South Carolina, Charleston, SC, USA
| | - Alan Snyder
- College of Medicine, Medical University of South Carolina, Charleston, SC, USA
| | - John Plante
- School of Medicine, University of South Carolina, Columbia, SC, USA
| | - Samantha Karlin
- Department of Dermatology and Dermatologic Surgery, Medical University of South Carolina, Charleston, SC, USA
| | - Lara Wine Lee
- Department of Dermatology and Dermatologic Surgery, Medical University of South Carolina, Charleston, SC, USA.,Department of Pediatrics, Medical University of South Carolina, Charleston, SC, USA
| | - Colleen H Cotton
- Department of Dermatology and Dermatologic Surgery, Medical University of South Carolina, Charleston, SC, USA.,Department of Pediatrics, Medical University of South Carolina, Charleston, SC, USA
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5
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Chen TH, Tseng YH, Wu YZ. Neonatal lupus. QJM 2020; 113:905-906. [PMID: 32311045 DOI: 10.1093/qjmed/hcaa134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- T-H Chen
- Division of Pediatric Emergency, Department of Pediatrics, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 80708, Taiwan and Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
| | - Y-H Tseng
- Division of Pediatric Emergency, Department of Pediatrics, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
| | - Y-Z Wu
- Division of Pediatric Emergency, Department of Pediatrics, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
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Blanc J, Bodak N, Saada V, Zavaro A, Bagot M, Petit A, Bourrat E. [Polymorphism and differential diagnosis of neonatal lupus erythematosus]. Ann Dermatol Venereol 2020; 147:258-264. [PMID: 32171550 DOI: 10.1016/j.annder.2019.09.613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Revised: 06/25/2019] [Accepted: 09/23/2019] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Neonatal lupus erythematosus (NEL) is a rare condition secondary to transplacental transfer of maternal anti-nuclear antibodies, generally anti-Ro/SSA. The most common signs are dermatological and cardiac. The most frequently reported clinical association is periorbital erythema, known as "owl eye", and bipolar erythematous maculopapular plaques with fine scales. However, many semiological variants can result in diagnostic errors or delays. PATIENTS AND METHODS This was a single-centre retrospective observational study collating all cases of NEL seen at paediatric dermatology consultations between 2010 and 2018. The diagnosis of NEL was confirmed by the presence of specific antinuclear antibodies (ANA) in the mother. The aim was to describe the different clinical forms of NEL and to discuss differential diagnosis. RESULTS AND DISCUSSION We identified ten cases of NEL, all addressed without diagnosis or with misdiagnosis. They were divided into 3 groups based on the semiology of skin lesions: 5 presented inflammatory macular papules on the cephalic extremity and head; 3 presented acquired periorbital depigmentation; 2 presented atrophic and diffuse livedoid lesions. None had heart disease and associated haematological and hepatic damage was mild. Spontaneous remission was seen in all cases before the age of 6 months. The mothers, who were generally symptom-free or paucisymptomatic, presented anti-Ro/SSA NAAs. CONCLUSION Recognition of the different clinical forms of NEL enables early institution of suitable therapy and monitoring of subsequent pregnancies.
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Affiliation(s)
- J Blanc
- Service de dermatologie, hôpital Robert-Debré, 75019 Paris, France.
| | - N Bodak
- Service de dermatologie, hôpital Trousseau, 75012 Paris, France
| | - V Saada
- Service de dermatologie, hôpital St Louis, 75010 Paris, France
| | - A Zavaro
- Cabinet médical, 94170 Le-Perreux-sur-Marne, France
| | - M Bagot
- Service de dermatologie, hôpital St Louis, 75010 Paris, France
| | - A Petit
- Service de dermatologie, hôpital St Louis, 75010 Paris, France
| | - E Bourrat
- Service de dermatologie, hôpital Robert-Debré, 75019 Paris, France
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7
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Franco C, Fortunato F, Maria AT, Marçal M. Recurrent central catheter complications in a newborn: can we blame neonatal lupus? BMJ Case Rep 2018; 2018:bcr-2017-223676. [PMID: 29437715 DOI: 10.1136/bcr-2017-223676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Affiliation(s)
- Catarina Franco
- Neonatal Intensive Care Unit, Centro Hospitalar de Lisboa Ocidental, Lisbon, Portugal.,Department of Pediatrics, Hospital of Divino Espírito Santo of Ponta Delgada, Ponta Delgada, Portugal
| | - Fabiana Fortunato
- Department of Pediatrics, Hospital de Caldas da Rainha, Caldas da Rainha, Portugal
| | - Ana Teresa Maria
- Department of Paediatrics, Hospital de Cascais, Cascais, Portugal
| | - Monica Marçal
- Neonatal Intensive Care Unit, Centro Hospitalar de Lisboa Ocidental, Lisbon, Portugal
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8
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Nisihara R, Pigosso YG, Prado N, Utiyama SR, De Carvalho GA, Skare TL. Rheumatic Disease Autoantibodies in Patients with Autoimmune Thyroid Diseases. Med Princ Pract 2018; 27:332-336. [PMID: 29864750 PMCID: PMC6170921 DOI: 10.1159/000490569] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2018] [Accepted: 06/04/2018] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Patients with autoimmune thyroid diseases (ATD) such as Graves' disease (GD) and Hashimoto thyroiditis (HT) may have non-organ specific autoantibodies such as antinuclear antibodies (ANA) and rheumatoid factor (RF). AIM To study the prevalence of rheumatic autoantibodies in a group of ATD patients without known rheumatic diseases and to evaluate its association with the patients' epidemiological and treatment profiles. To follow positive non-organ specific autoantibody-positive ATD individuals to investigate whether they will develop a rheumatic disorder. METHODS A sample of 154 ATD patients (70 HT and 84 GD; mean age 45.3 ± 14.2) had determination of ANA by immunofluorescence, using hep-2 cells as substrate, extractable nuclear antigen profile by ELISA kits and RF by latex agglutination. Epidemiological and treatment profiles were obtained through chart review. These patients were followed for the mean period of 5 years, between 2010 and 2015. RESULTS Positive ANA was found in 17.5% (27/154) of the patients: anti-Ro/SS-A in 4/154 (2.5%); anti-RNP in 4/154 (2.5%), and anti-La/SS-B in 3/154 (1.9%). None had anti-Sm antibodies. RF was detected in 12/154 (7.7%) of ATD patients and was more common in older individuals (p = 0.007). There was a positive association between the presence of RF and ANA (p = 0.03; OR 3.89; 95% CI 1.1-13.3). None of the patients with positive autoantibodies developed clinical rheumatic diseases during the period of observation. CONCLUSION We found rheumatic autoantibodies in 17.5% of ATD patients without rheumatic diseases. None of them were associated with the appearance of clinical rheumatic disorder during the period of 5 years.
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Affiliation(s)
- Renato Nisihara
- Laboratory of Immunopathology, Clinical Hospital, Federal University of Paraná, Curitiba, Brazil
- Department of Medicine, Positivo University, Curitiba, Brazil
- *Dr. Renato Nisihara, Laboratory of Immunopathology, Clinical Hospital, Federal University of Paraná, Rua Padre Camargo 280, Curitiba 80060-240 (Brazil), E-Mail
| | | | - Nathalia Prado
- Department of Medicine, Positivo University, Curitiba, Brazil
| | - Shirley R.R. Utiyama
- Laboratory of Immunopathology, Clinical Hospital, Federal University of Paraná, Curitiba, Brazil
- Department of Clinical Analysis, Federal University of Paraná, Curitiba, Brazil
| | - Gisah A. De Carvalho
- Endocrinology Service, Clinical Hospital, Federal University of Paraná, Curitiba, Brazil
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9
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Rotstein Grein IH, Armbrust W, van der Molen AM, van Royen-Kerkhof A. Juvenile idiopathic arthritis in a patient with previous diagnosis of severe congenital lupus. Lupus 2017. [PMID: 28649905 DOI: 10.1177/0961203317709345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Neonatal lupus (NL) is an acquired autoimmune disease of the newborn, caused by transplacental passage of the maternal autoantibodies anti SS-A/Ro and anti SS-B/La. When the clinical picture starts directly at birth, it is known as congenital lupus (CL). The clinical manifestations are variable. Except for cardiac involvement, the other manifestations tend to be benign, and resolve with the child's clearance of maternal antibodies. We report a patient who presented at birth with very severe involvement of the skin, and subsequent contractures of hands and feet, leading to functional impairment. The patient underwent surgical procedures with excellent result. At the age of 18 months, the patient was diagnosed with oligoarticular juvenile idiopathic arthritis (JIA), and bilateral uveitis at the age of 3 years and a half. Our aim is to alert health professionals about the possibility of a severe course of cutaneous manifestations in CL, as well as the role of CL and NL regarding development of other autoimmune diseases.
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Affiliation(s)
- I H Rotstein Grein
- 1 Department of Pediatrics, Wilhelmina Children's Hospital/University Medical Centre Utrecht, Utrecht, the Netherlands.,2 Department of Pediatric Rheumatology, Hospital Pequeno Príncipe, Curitiba, Paraná, Brazil
| | - W Armbrust
- 3 Department of Pediatrics, University Medical Centre Groningen, Groningen, the Netherlands
| | - A M van der Molen
- 4 Department of Surgery, Wilhelmina Children's Hospital/University Medical Centre Utrecht, Utrecht, the Netherlands
| | - A van Royen-Kerkhof
- 1 Department of Pediatrics, Wilhelmina Children's Hospital/University Medical Centre Utrecht, Utrecht, the Netherlands
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10
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Neonatal lupus: Follow-up in infants with anti -SSA/Ro antibodies and review of the literature. Autoimmun Rev 2017; 16:427-432. [DOI: 10.1016/j.autrev.2017.02.010] [Citation(s) in RCA: 65] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2017] [Accepted: 02/12/2017] [Indexed: 11/20/2022]
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11
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Schwartz J, Padmanabhan A, Aqui N, Balogun RA, Connelly-Smith L, Delaney M, Dunbar NM, Witt V, Wu Y, Shaz BH. Guidelines on the Use of Therapeutic Apheresis in Clinical Practice-Evidence-Based Approach from the Writing Committee of the American Society for Apheresis: The Seventh Special Issue. J Clin Apher 2017; 31:149-62. [PMID: 27322218 DOI: 10.1002/jca.21470] [Citation(s) in RCA: 276] [Impact Index Per Article: 39.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
The American Society for Apheresis (ASFA) Journal of Clinical Apheresis (JCA) Special Issue Writing Committee is charged with reviewing, updating, and categorizing indications for the evidence-based use of therapeutic apheresis in human disease. Since the 2007 JCA Special Issue (Fourth Edition), the Committee has incorporated systematic review and evidence-based approaches in the grading and categorization of apheresis indications. This Seventh Edition of the JCA Special Issue continues to maintain this methodology and rigor to make recommendations on the use of apheresis in a wide variety of diseases/conditions. The JCA Seventh Edition, like its predecessor, has consistently applied the category and grading system definitions in the fact sheets. The general layout and concept of a fact sheet that was used since the fourth edition has largely been maintained in this edition. Each fact sheet succinctly summarizes the evidence for the use of therapeutic apheresis in a specific disease entity. The Seventh Edition discusses 87 fact sheets (14 new fact sheets since the Sixth Edition) for therapeutic apheresis diseases and medical conditions, with 179 indications, which are separately graded and categorized within the listed fact sheets. Several diseases that are Category IV which have been described in detail in previous editions and do not have significant new evidence since the last publication are summarized in a separate table. The Seventh Edition of the JCA Special Issue serves as a key resource that guides the utilization of therapeutic apheresis in the treatment of human disease. J. Clin. Apheresis 31:149-162, 2016. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Joseph Schwartz
- Department of Pathology and Cell Biology, Columbia University Medical Center, New York, New York
| | - Anand Padmanabhan
- Blood Center of Wisconsin, Department of Pathology, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Nicole Aqui
- Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Rasheed A Balogun
- Division of Nephrology, University of Virginia, Charlottesville, Virginia
| | - Laura Connelly-Smith
- Department of Medicine, Seattle Cancer Care Alliance and University of Washington, Seattle, Washington
| | - Meghan Delaney
- Bloodworks Northwest, Department of Laboratory Medicine, University of Washington, Seattle, Washington
| | - Nancy M Dunbar
- Department of Pathology and Laboratory Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire
| | - Volker Witt
- Department for Pediatrics, St. Anna Kinderspital, Medical University of Vienna, Vienna, Austria
| | - Yanyun Wu
- Bloodworks Northwest, Department of Laboratory Medicine, Yale University School of Medicine, New Haven, Connecticut
| | - Beth H Shaz
- Department of Pathology and Cell Biology, Columbia University Medical Center, New York, New York.,New York Blood Center, Department of Pathology.,Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, Georgia
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12
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Acute Disseminated Encephalomyelitis. J Clin Apher 2016; 31:163-202. [PMID: 27322219 DOI: 10.1002/jca.21474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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13
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Abstract
We report a case of dichorionic, diamniotic twins who developed similar erythematous, annular, erosive plaques in the inguinal folds in the first few weeks of life that were refractory to topical antifungals and oral antibiotics. The twins were found to have high transaminase levels, antinuclear antibody positivity, and anti-SSS/Ro) and anti-SSB/La autoantibodies. The rash resolved without scarring by 7 months of age with the use of low-potency topical corticosteroids. We suggest that physicians consider neonatal lupus erythematosus in neonates with atypical eruptions occurring in sun-protected skin.
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Affiliation(s)
- Lacy L Sommer
- Cooper Medical School of Rowan University, Camden, New Jersey
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14
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Ngo ST, Steyn FJ, McCombe PA. Gender differences in autoimmune disease. Front Neuroendocrinol 2014; 35:347-69. [PMID: 24793874 DOI: 10.1016/j.yfrne.2014.04.004] [Citation(s) in RCA: 583] [Impact Index Per Article: 58.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2014] [Revised: 04/20/2014] [Accepted: 04/22/2014] [Indexed: 12/21/2022]
Abstract
Autoimmune diseases are a range of diseases in which the immune response to self-antigens results in damage or dysfunction of tissues. Autoimmune diseases can be systemic or can affect specific organs or body systems. For most autoimmune diseases there is a clear sex difference in prevalence, whereby females are generally more frequently affected than males. In this review, we consider gender differences in systemic and organ-specific autoimmune diseases, and we summarize human data that outlines the prevalence of common autoimmune diseases specific to adult males and females in countries commonly surveyed. We discuss possible mechanisms for sex specific differences including gender differences in immune response and organ vulnerability, reproductive capacity including pregnancy, sex hormones, genetic predisposition, parental inheritance, and epigenetics. Evidence demonstrates that gender has a significant influence on the development of autoimmune disease. Thus, considerations of gender should be at the forefront of all studies that attempt to define mechanisms that underpin autoimmune disease.
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Affiliation(s)
- S T Ngo
- School of Biomedical Sciences, University of Queensland, St Lucia, Queensland, Australia; University of Queensland Centre for Clinical Research, University of Queensland, Herston, Queensland, Australia
| | - F J Steyn
- School of Biomedical Sciences, University of Queensland, St Lucia, Queensland, Australia
| | - P A McCombe
- University of Queensland Centre for Clinical Research, University of Queensland, Herston, Queensland, Australia; Department of Neurology, Royal Brisbane & Women's Hospital, Herston, Queensland, Australia.
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