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.