2.2 | Case 2
6 years later, the mother became pregnant a second time, at 4 weeks of pregnancy, the test found both the SSA (Ro) and SSB (La) were strongly positive, ANA was reactive >1:1000 with multiple nuclear dots, ESR was 90mm/h (normal < 10mm/h). Considering that the mother’s condition was active, the doctor recommended termination of pregnancy, but the mother did not accept it and was aware of the risk of malformation and abortion if continuing pregnancy. During pregnancy, the mother was treated with prednisone 10mg/d, hydroxychloroquine 400mg/d and calcium carbonate 600mg/d.
A male infant (patient 2) was born at 39 weeks’ gestation by performing a caesarean section because of fetal macrosomia, with a birthweight of 4500g. One week after birth, the child gradually developed a rash dominated by erythema and papules (Fig. 2a), which was quite different from the rash of his sister. The test found both the SSA (Ro) and SSB (La) were positive, ANA was reactive 1:100 with multiple nuclear dots. Skin biopsy showed vacuolar change of epidermal basal cells, perivascular and periadnexal mononuclear infiltrate in the dermis (Fig. 2b). A diagnosis of NLE was made as his sister. The rash start to partially subside from two and a half months. At present, he is still in follow-up. Written informed consent was obtained from the parents of the patient for publication of this case report and accompanying images.