Effect of Maternal SLE on the baby - USMLE Forums
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Old 11-15-2012
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Pediatrics Effect of Maternal SLE on the baby

A 31-year-old woman with systemic lupus erythematous (SLE) is 4 weeks pregnant, and presents to her obstetrician for her first prenatal visit. She is very concerned that the lupus will affect her baby. She was diagnosed with SLE 5 years ago and her symptoms have been well controlled on low-dose prednisone. She has baseline renal insufficiency, with a creatinine of 1.3 mg/dL, which has been stable for the past 6 months. This is her first pregnancy. For which of the following is the baby at increased risk?

(A) Acute renal failure
(B) Chorioretinitis
(C) Complete heart block
(D) Ebstein’s anomaly
(E) Rash

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(C) Complete heart block
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Old 11-15-2012
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a classic question.......heart blocks....
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Old 11-15-2012
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Yup The correct answer is C. Neonatal lupus is caused by passive transfer of IgG autoantibodies cross the placenta. so screening should be done at the beginning of prenatal care to determine the risk of neonatal lupus and the need for monitoring.Clinical features are cutaneous lesions, hepatitis, thrombocytopenia, neutropenia, and heart block. All are temporary except heart block which is most serious complication may require pacing. Fetuses at risk of neonatal lupus should have regular Doppler echocardiography to screen for the development of heart block.
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Old 11-17-2012
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just wanted to bring it to notice. heart block is the most common thing affecting the baby.
vs libmann sacks endocarditis affects only 5% of mother. so either ways never pick lse. unless they specifically ask which endocarditis is seen. i know its not in the options but i had seen it somewhere.
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Old 11-17-2012
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(C) Complete heart block
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