scholarly journals Pulmonary Involvement in Neonatal Lupus from Clinical Diagnoses to Autopsy Findings: A Case Report

2021 ◽  
Author(s):  
Fan Wu ◽  
Li Ying ◽  
Xiong Hanzhen ◽  
Lin Lili ◽  
Huang Weiliang
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
Interstitial Fibrosis ◽  
Pulmonary Involvement ◽  
Lung Damage ◽  
Systemic Lupus ◽  
Neonatal Lupus ◽  
Chronic Inflammatory Cell ◽  
Autopsy Findings ◽  
Clinical Diagnoses

Abstract Background: Neonatal lupus erythematosus (NLE) is an uncommon immunemediated disease caused by the transplacental passage of maternal autoantibodies. In this paper, we described a case of a newborn with NLE involving lung damage from clinical diagnoses to autopsy findings. Case presentation: The mother had no history of immune system disease; however, the test for antinuclear antibodies was positive. A boy was delivered spontaneously at 36+2 weeks’ gestation without asphyxia (birth weight: 1.21 kg, length: 38 cm, head circumference: 26 cm). Soon after birth, intermittent shortness of breath occurred, followed by cyanosis and severe hypoxemia. Blood tests suggested that the infant was positive for anti-nuclear antibodies. Although multiple respiratory support methods were used, death could not be avoided and occurred at 6.5 days due to cardiopulmonary failure. The results of the autopsy revealed diffuse interstitial inflammation and interstitial fibrosis in both lungs, manifesting as telangiectasia, hyperemia, alveolar cavity dilatation and fusion, and obvious interstitial widening with chronic inflammatory cell infiltration. The newborn was finally diagnosed with nonspecific interstitial pneumonia with fibrosis caused by congenital systemic lupus erythematosus. Conclusions: Pulmonary involvement with NLE is a diagnostic challenge at present. Close attention should be given to newborns whose mothers have systemic lupus erythematosus.

Clinical case of lung lesions in patient with newly diagnosed systemic lupus erythematosus

2019 ◽  
Vol 1 (9) ◽  
pp. 53-57
Author(s):  
T. N. Gavva ◽  
L. V. Kuzmenkova ◽  
Yu. N. Fedulaev ◽  
T. V. Pinchuk ◽  
D. D. Kaminer ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
Clinical Case ◽  
Clinical Manifestations ◽  
Lung Damage ◽  
Newly Diagnosed ◽  
Systemic Lupus ◽  
Lung Lesions ◽  
Laboratory Parameters ◽  
Clinical Interest

A case of lung damage in systemic lupus erythematosus (SLE) in a 33-year-old woman is described. This case is of clinical interest due to the complexity of diagnosis due to the fact that SLE is a disease with diverse clinical manifestations involving many organs and systems, which often makes it difficult to timely recognize the onset of the disease. SLE still remains a challenge and requires special attention to the patient s history, clinical and laboratory parameters of the patient, as well as specific immunological examinations.

scholarly journals POS0722 HISTOPATHOLOGICAL ANALYSIS OF LUPUS NEPHRITIS INCORPORATING BANFF CRITERIA EMPHASIZES THE IMPORTANCE OF TUBULOINTERSTITIAL CHANGES FOR CREATININE AND PROTEINURIA AT 12 MONTHS AFTER RENAL BIOPSY

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 611.1-611
Author(s):  
M. Plüß ◽  
S. Hakroush ◽  
N. Niebusch ◽  
B. Tampe ◽  
P. Korsten
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Lupus Nephritis ◽  
Lupus Erythematosus ◽  
Interstitial Fibrosis ◽  
Laboratory Data ◽  
Histopathological Analysis ◽  
Systemic Lupus ◽  
Long Term Outcome ◽  
Banff Classification ◽  
Tubulointerstitial Inflammation

Background:Lupus nephritis (LN) occurs in about 30-60% of patients with systemic lupus erythematosus (SLE). LN is associated with increased mortality. Currently, the diagnosis relies on histopathologic characteristics according to the ISN/RPS classification (1). This classification relies heavily on glomerular changes and may not accurately reflect all changes occurring in LN. For the description of transplanted kidney, the BANFF classification has been established which, in addition to glomerular changes, also incorporates tubular pathologies (2).Objectives:With the present study, we aim to describe histopathologic changes according to the BANFF classification in a single-center cohort of LN patients.Methods:We retrospectively recorded epidemiological, clinical and laboratory data of 58 patients with LN over a ten-year period. Histopathologic diagnoses according to ISN/RPS classification or the former WHO classification were also documented. We then re-analyzed representative kidney samples according to the BANFF classification and performed Spearman rank correlation for BANFF findings and creatinine at biopsy and 12 months as well as proteinuria at biopsy and at 12 months.Results:We analyzed 58 patients with LN. 9 were male, 49 were female. Median age was 38 (15-78) years. According to ISN/RPS, 3 had class I LN, 6 had class II, 14 had class III, 16 had class IV, 6 had class V, and 0 had class VI. Median eGFR at biopsy was 60 ml/min/1.73m2 (13-137). According to the BANFF classification, tubulointerstitial inflammation (ti) was associated with creatinine at 12 months. Proteinuria at 12 months was associated with interstitial fibrosis (ci) (Figure 1).Conclusion:In LN, the current ISN/RPS classification puts emphasis on glomerular changes. Nevertheless, for the long-term outcome, tubulointerstitial changes (tubulointerstitial inflammation and interstitial fibrosis) may at least be as important as glomerular changes. These findings have to be corroborated in larger cohorts with prespecified renal endpoints.References:[1]Weening et al. The classification of glomerulonephritis in systemic lupus erythematosus revisited. JASN 2004.[2]Jeong HY. Diagnosis of renal transplant rejection: Banff classification and beyond. Kidney Res Clin Pract 2020.Disclosure of Interests:Marlene Plüß: None declared, Samy Hakroush: None declared, Noah Niebusch: None declared, Björn Tampe: None declared, PETER KORSTEN Speakers bureau: Abbvie, Pfizer, Chugai, Sanofi, Boehringer-Ingelheim, GSK, Novartis, Consultant of: Abbvie, Pfizer, Chugai, Sanofi, Boehringer-Ingelheim, GSK, Novartis, Lilly, Gilead, Grant/research support from: GSK

scholarly journals Neonatal Lupus and Complete Atrioventricular Block: Case Report in Mexico

2021 ◽  
pp. 1-7
Author(s):  
Carla Eugenia Arenas Alvarez ◽  
Juan Carlos Marin Mireles ◽  
Hebert Israel Flores Leal ◽  
Ana Norma Griselda Becerril Gonzalez ◽  
Carlos Mario Guzman Sanchez
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Atrioventricular Block ◽  
Gestational Age ◽  
Lupus Erythematosus ◽  
Fetal Echocardiography ◽  
Fetal Mortality ◽  
Complete Atrioventricular Block ◽  
Systemic Lupus ◽  
Neonatal Lupus ◽  
Complete Atrioventricular

Aims: To describe a case of neonatal lupus and complete atrioventricular block in Mexico. Presentation of case: A 38 years old pregnant patient at  28 + 6 weeks of gestational age, diagnosed with systemic lupus erythematosus six years ago, under treatment with hydroxychloroquine and prednisone, this was suspended eight months prior to pregnancy; and resumed at week 20 of gestational age. The ultrasound scan showed alive fetus, female, polyhydramnios and bradycardia. Fetal echocardiography confirmed complete atrioventricular block, without organic and structural alterations at the cardiac level. Furthermore, the immunological panel reports, positive anti-Ro antibodies. At week 33 of gestational age, the patient was admitted to the obstetric emergency room, through colic type pain and 4 cm dilation of the cervix. Alive newborn got vaginally with a weight of 1,990 g, a height of 43 cm and APGAR 8-9. Echocardiography confirmed congenital complete third degree atrioventricular block; without structural abnormalities. Discussion: Patients with systemic lupus erythematosus, are more likely to have complications during pregnancy. Neonatal lupus is a rare disorder with an incidence of 1:10,000 - 1:20,000 newborns. This is caused by the transplacental passage of maternal autoantibodies anti-SSA / Ro and/or anti-SSB / La. Besides Atrioventricular block is a complication of neonatal lupus, occurring in approximately 2% of newborns of mothers who have SSA or SSB antibodies. The most interesting finding is that 20% fetal mortality has been for this cause. Conclusion: The described case is important for its rarity. Besides, the imaging findings and immunological panel emphasized the relevance about complete and adequate evaluation of the fetus, in the context of a mother with systemic lupus erythematosus.

Cardio-pulmonary involvement in juvenile systemic lupus erythematosus

Lupus ◽  
2005 ◽  
Vol 14 (2) ◽  
pp. 152-158 ◽  
Author(s):  
M W Beresford ◽  
A G Cleary ◽  
J A Sills ◽  
J Couriel ◽  
J E Davidson
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
Pulmonary Involvement ◽  
Systemic Lupus ◽  
Juvenile Systemic Lupus Erythematosus
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