394 First report of intrauterine pericardiocentesis in a fetus with neonatal lupus erythematosus

Abstract

in 11 babies (including a pair of twin). Caesarean operations were performed in 14 courses (including a pair of twin). Conclusions In our hospital, we could well manage the course of pregnancy associated with SLE. Background and aims Neonatal lupus erythematosus (NLE) is a passively acquired autoimmune disease of infancy, caused by the transplacental passage of maternal autoantibodies, mostly anti-RO/SSA and anti-LA/SSB. NLE presents with a transient rash and/ or congenital heart block (CHB). The risk of developing NLE in SSA-positive women is~2%, however the risk increases to 25%, if the mother has had a previous child with NLE. Objectives We present a case of NLE characterised by a thirddegree CHB, ascites and life-threatening pericardial effusion, which was treated twice with intrauterine pericardiocentesis in week 22 and 29. After birth the child was treated with systemic corticosteroid on and off for 1 year, and she later received a pacemaker and was treated with ACE inhibitor and diuretics due to heart failure. Now, at the age of 6 years, she is still treated with ACE inhibitor. Her older sister also had NLE and her mother was found to have asymptomatic anti-SSA >100 U/ml. Discussion This case is exceptional, as the fetus had severe exudative pericarditis and had life-saving pericardiocentesis performed in utero. We want to draw the clinicians' attention to the increased risk of NLE, when a mother earlier has given birth to a child with NLE. Regular fetal echocardiography is important from week 16. In case of first-and second-degree CHB, maternal corticosteroid can be tried to reverse the condition. Also, treatment with hydroxychloroquine or IVIG may decrease the risk of CHB. 394 FIRST REPORT OF INTRAUTERINE PERICARDIOCENTESIS IN A FETUS WITH NEONATAL LUPUS ERYTHEMATOSUS 395 MATERNAL AND FETAL OUTCOMES AMONG FILIPINO PATIENTS WITH SYSTEMIC LUPUS ERYTHEMATOSUS: A SINGLE CENTRE STUDYCA Dela Cruz-Tan*. University of Santo Tomas Hospital, Rheumatology, Manila, Philippines 10. 1136/lupus-2017-000215.395 Background and aims Systemic lupus erythematosus (SLE) usually affects women of child-bearing age, with pregnancy thus posing a relevant management challenge. This paper describes materno-fetal outcomes among Filipino SLE patients in a single tertiary care centre. Methods We retrospectively reviewed the medical files of patients in the Lupus Database of the University of Santo Tomas Hospital in Manila, Philippines, who had a recorded pregnancy after SLE diagnosis, describing the maternal and fetal outcomes of each pregnancy. Results There were a total of 197 pregnancies among 99 patients. Average age at first pregnancy was 29 years old. Lupus Nephritis (LN) was present in 13.7%, hyperthyroidism 1.0%, and autoimmune thyroiditis 1.0%. Maternal complications intra-and post-partum included hypertension (5.6%), pulmonary tuberculosis (TB) (4.0%), pre-eclampsia (3.6%), HELLP syndrome, gestational diabetes (GDM) (3.0%), urinary tract infections (UTI) (3.0%), herpes zoster (2.0%) and 0.5% cases each of TB meningitis,...