nefrНефрологияNephrology (Saint-Petersburg)1561-62742541-9439Pavlov First Saint-Petersburg State Medical University10.36485/1561-6274-2020-24-2-88-95nefr-1804Research ArticleНАБЛЮДЕНИЯ ИЗ ПРАКТИКИPRACTICAL NOTESРазвитие неонатальной волчанки у одного из двух детей при дихориальной диамниотической беременности у женщины с нераспознанной системной красной волчанкой с поражением почекСase of neonatal lupus in one of two children of dichorial diamniotic pregnancy in a woman with unrecognized systemic lupus erythematosus and lupus nephritishttps://orcid.org/0000-0002-6125-590XКирсановаТ. В.KirsanovaT. V.

Старший научный сотрудник Кирсанова Татьяна Валерьевна канд. мед. наук.

Отделение гравитационной хирургии крови.

117997, Москва, ул. Академика Опарина, д. 4Тел.: (826)2484560 

Senior Researcher Tatiana V. Kirsanova MD, PhD.

117997, 4, Oparina street, MoscowPhone: (826)2484560 

a_tatya@mail.ruhttps://orcid.org/0000-0001-7190-9199КравченкоН. Ф.KravchenkoN. F.

Старший научный сотрудник Кравченко Наталья Федоровна канд. мед. наук.

1-е акушерское отделение патологии беременности, старший научный сотрудник.

117997, Москва, ул. Академика Опарина, д. 4

Senior Researcher Natalia F. Kravchenko, MD, PhD.

117997, 4, Oparina street, Moscow

natakravchenko11@gmail.comhttps://orcid.org/0000-0003-0362-580XБалакиреваА. И.BalakirevaA. I.

Аспирант Балакирева Алина Игоревна.

Факультет фундаментальной медицины, кафедра внутренних болезней.

117192, Россия, Москва, ул. Ломоносовский пр., д. 27-1Тел.: (985)9759016 

Postgraduate student Alina I. Balakireva, MD.

Faculty of Fundamental Medicine.

117192, 31-5 Lomonosovsky Prospekt, MoscowPhone: (985)9759016 

koluvanova@gmail.comНациональный медицинский исследовательский центр акушерства, гинекологии и перинатологии имени академика В.И. КулаковаРоссияAcademician V.I. National Medical Research Center for Obstetrics, Gynecology and Perinatology KulakovaRussian FederationМосковский государственный университет имени М.В. ЛомоносоваРоссияMoscow State University named after M.V. LomonosovRussian Federation2020080220202428895Copyright © Кирсанова Т.В., Кравченко Н.Ф., Балакирева А.И., 20202020Кирсанова Т.В., Кравченко Н.Ф., Балакирева А.И.Kirsanova T.V., Kravchenko N.F., Balakireva A.I.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://journal.nephrolog.ru/jour/article/view/1804

Возможность реализовать репродуктивную функцию как больным с системной красной волчанкой, так и больным с иной причиной хронической болезни почек, по праву рассматривается как одно из важнейших достижений современной медицины. В статье представлено описание течения беременности пациентки с системной красной волчанкой и вторичным антифосфолипидным синдромом. На первый план в клинической картине выходило поражение почек с развитием почечной тромботической микроангиопатии, что расценивалось как нефрит и затрудняло диагностику системной красной волчанки. Достигнут положительный исход беременности с развитием неонатальной волчанки у одного ребенка из двойни. Обсуждаются варианты профилактики и лечения тромботических осложнений и способы минимизации гестационных осложнений с назначением низкомолекулярных гепаринов и препаратов ацетилсалициловой кислоты. Также описаны варианты терапии для улучшения исходов подобных беременностей и снижения выраженности симптомов неонатальной волчанки с использованием гидроксихлорохина. В статье обобщаются современные подходы к ведению таких пациенток, особое внимание уделяется междисциплинарному подходу.

The ability to realize the reproductive function for both patients with systemic lupus erythematosus and patients with a different cause of chronic kidney disease is rightfully considered as one of the most important achievements of modern medicine. The work describes the pregnancy case of the patient with systemic lupus erythematosus and secondary antiphospholipid syndrome. Renal damage with the development of renal thrombotic microangiopathy came to the fore in the clinical picture, which was regarded as nephritis and complicated the diagnosis of systemic lupus erythematosus. A positive pregnancy outcome was achieved with the development of neonatal lupus erythematosus in one twin child. The options for the prevention and treatment of thrombotic complications as well as methods for minimizing gestational complications (including preeclampsia, which the patient had in history) are discussed, inter alia, with the purposed of low-molecular-weight heparins and acetylsalicylic acid preparations. Treatment options are also described to improve the outcome of such pregnancies and to decrease the symptoms of neonatal lupus erythematosus using hydroxychloroquine. The article summarizes current management approaches for these patients with special attention to the interdisciplinary approach.

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The authors declare that there are no conflicts of interest present.