NEONATAL LUPUS ERİTEMATOZUSA BAĞLI HEMATOLOJİK, HEPATİK, NÖROLOJİK VE PULMONER TUTULUMUNUN GÖZDEN GEÇİRİLMESİ: HASTA BAZLI SİSTEMATİK LİTERATÜR TARAMASI

Öz

Amaç: Neonatal lupus eritematozus, anti-SS-A/Ro ve anti SS-B/La antikorlarının transplasental geçişiyle fetal dokulara bağlanması sonucu ortaya çıkan edinsel otoimmün bir hastalıktır. Kütanöz, kardiyak, hepatik, nörolojik, akciğer ve hematolojik bulgularla ortaya çıkabilir. Literatürdeki bilgi birikimi daha çok kütanöz ve kardiyak tutulumu ağırlıklıdır. Bu çalışmanın amacı, literatür taraması yaparak hepatik, nörolojik, akciğer ve hematolojik tutulumumların gözden geçirilmesidir. Gereç ve Yöntem: 1976 yılından Ağustos 2015 tarihini kapsayacak şekilde Pubmed Medline’da literatür taraması yapıldı. MeSH terimleri kullanılarak yayınlar belirlendi: (''konjenital kalp bloğu, neonatal lupus‘' (MeSH)), ‘'insanlar'', ''İngilizce'' ile kısıtlamaları yapılarak tarandı. Vakaların bilgilerinin hasta bazında raporlandığı makaleler son analize dahil edildi. Hematolojik, hepatik, nörolojik ve akciğer tutulumu olan NLE hastalarının demografik, klinik ve laboratuvar verileri kaydedildi. Bulgular: Toplam 755 NLE hastasının verileri kaydedildi. Bu hastaların 117 (%15,5)’sinde hematolojik, 78 (%10,3)’inde hepatik, 10 (%1,3)’unda akciğer (%1.3) ve 9 (%1,2)’unda nörolojik tutulum saptanmıştır. Sonuç: Neonatal lupus eritematozus’da hematolojik, hepatik, akciğer ve nörolojik tutulum, kardiyak ve cilt tutulumuna göre daha az görülmektedir. Buna ragmen, klinisyenler NLE yönetimi sürecinde görülebilen bu tutulumlar açısından uyanık olmalılardır.

Anahtar Kelimeler

• Neonatal lupus eritematozus
• hepatik tutulum
• nörolojik tutulum
• hematolojik tutulum

EVALUATION OF HEMATOLOGICAL, NEUROLOGICAL, HEPATIC AND PULMONARY INVOLVEMENTS OF NEONATAL LUPUS ERYTHEMATOSUS: PATIENT-BASED SYSTEMATIC LITERATURE REVIEW

Öz

AIM: Neonatal lupus erythematosus (NLE) is an acquired autoimmune disease mainly caused by transplacental transition of anti-SS-A/Ro and anti SS-B/La antibodies. Cutaneous, cardiac, hepatic, neurologic, hematologic and pulmonary involvement can be seen. In current literature, data regarding cutaneous and cardiac involvement comprises the vast majority about NLE. Aim of this study was to review the current literature regarding hematologic, hepatic, neurologic, and pulmonary involvement of NLE in a case-based systematic review manner. MATERIAL AND METHOD: We conducted a systematic literature review on PubMed MEDLINE (from 01.01.1976 to 31.08.2015) with the MeSH words “congenital heart block, neonatal lupus’’. Search was limited to ‘’humans’’ and articles in English language. Articles reporting individual patient’s data were included into final analysis. Demographic, clinical and laboratory data of NLE cases with hematologic, hepatic, neurologic, and pulmonary involvement were recorded. RESULTS: Total of 755 NLE patients were recruited. Of these patients, 117 (15.5%) had hematologic involvement, 78 (10.3%) had hepatic involvement, 10 (1.3%) had pulmonary involvement and 9 (1.2%) had neurologic involvement. CONCLUSION: Hematologic, hepatic, pulmonary, and neurologic involvement were less common than cardiac and cutaneous involvement in NLE patients. Nonetheless, clinicians should keep in mind these involvements while managing the NLE patients. 

Anahtar Kelimeler

• Neonatal lupus erythematosus
• hepatic
• neurologic
• pulmonary
• hematologic involvement

Kaynakça

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