日本未熟児新生児学会雑誌　第24巻第1号　105～108頁（2012年）

日本未熟児新生児学会雑誌　24(1)：105-108；2012　

受付日：平成23．04．18

受理日：平成23．07．26

無症候の抗リン脂質抗体陽性母体から出生し，脳深部白質に多発結節性病変を認めた新生児例

Multiple Nodular Lesions in Deep White Matter in a Neonate Born to a Mother with Antiphospholipid Antibody

群馬県立小児医療センター　新生児科

Department of Neonatology, Gunma Children’s Medical Center

井上文孝・丸山憲一・藤生　徹・浦野博央・井上貴博・関矢亜矢子・市之宮健二

Fumitaka INOUE，Kenichi MARUYAMA，Tohru FUJIU，Hironaka URANO，Takahiro INOUE，Ayako SEKIYA，Kenji ICHINOMIYA

Key Words：antiphospholipid antibody，brain，white matter，MRI，neonate

　脳深部白質に一過性の多発結節性病変を認め，その原因検索中に母体の抗リン脂質抗体が陽性であることが判明した新生児例を報告する。症例は母親に特に既往歴のない男児。在胎35週0日，出生体重2,518g，Apgarscore1分後9点，5分後9点。早産児のため当科入院。日齢6に施行した頭部MRIで偶然，脳深部白質にT1，T2値が短縮し，拡散強調像やFLAIR像で高信号を示す結節状の異常信号域を多数認めた。母児ともに症状はなかったが，抗リン脂質抗体陽性であった。全身状態は良好であり日齢20に退院した。生後8か月の頭部MRIでは異常を認めず，発達も特に問題なかった。本症例の白質病変の出現には，児に移行した抗リン脂質抗体が関与していた可能性がある。今後，症例を集積し，母体抗リン脂質抗体と新生児の白質の脳血管性病変との関連について検討する必要がある。

　We report the case of transient multiple nodular lesions observed in the deep white matter of a neonate whose mother was found to be positive for antiphospholipid antibody. The patient was a male baby and the mother’s medical history was unremarkable. His gestational age was 35 weeks 0 days, birth weight was 2,518g, and Apgar score was 9 at 1 min and 9 at 5 min. The patient was admitted to our department because of prematurity. No particular clinical manifestations were noted, but MRI of the head performed on postnatal day 6 revealed shortening of the T1 and T2 values in the deep white matter, and we observed many nodular abnormal signal areas that appeared as high signal intensities on diffusionweighted images and FLAIR images. The mother and the infant both tested positive for antiphospholipid antibody. The infant’s general condition was favorable, and he was discharged on postnatal day 20. MRI examination of the head at 8 months of age showed no abnormal findings, and there were no particular developmental problems. Antiphospholipid antibodies that crossed into the infant may have been involved in the white matter lesions in this case.