Chinese Journal of Perinatal Medicine

Objective
To investigate the clinical characteristics of neonatal multi-system Langerhans cell histiocytosis.


Methods
A female neonate with multi-system Langerhans cell histiocytosis in Guangzhou Women and Children's Medical Center in March, 2013 was reported and related literature was reviewed. The clinical manifestations, and laboratory test, imaging examination and biopsy results were analyzed.


Results
The neonate had onset of jaundice and rash, then was found to have hepatomegaly, splenomegaly, lymphadenopathy and abnormal blood test. The lymph node biopsy revealed infiltration of Langerhans cells and eosinophils, which were positive for CD1a/S-100 stains. She was diagnosed with multi-system Langerhans cell histiocytosis. Sixty-two cases of neonatal multi-system Langerhans cell histiocytosis were reviewed in the literature, and the most common clinical manifestations included rash, hepatomegaly, respiratory symptoms, imaging changes, abnormal blood test, digestive symptoms and lymphadenopathy. The most frequently involved organs included lung, liver, spleen, bone marrow, bone, gastrointestinal tract, lymph node and mucosa, among which the risky organs (liver, spleen, blood system and lung) accounted for 88.7%(55/62).


Conclusions
The incidence rate of multi-system Langerhans cell histiocytosis is low in neonates, and it is characterized by multi-system involvement, especially the liver, spleen, blood system, lung and skin. For the neonates diagnosed without intrauterine infections, besides skin biopsy, lymphadenopathy should be dynamically observed and lymph node biopsy should be done earlier so as to establish an early diagnosis.


Key words: 
Histiocytosis, Langerhans-cell; Multiple organ failure; Lymphatic diseases; Infant, newborn

Rui Gu

Wei Zhou

Xiaowen Chen

Xiaohong Huang

Li Tao

Zhonghua weichan yixue zazhi

Multi-system Langerhans cell histiocytosis in a neonate: a case report and literature review

新生儿多系统朗格汉斯细胞组织细胞增生症：病例报告与文献综述

We report a critically ill pregnant woman in the third trimester with severe pneumonia due to COVID-19 who presented to Xiaolan People's Hospital of Zhongshan in February 2020 The 32-year-old patient was admitted at 35+2 gestational weeks with a 4-day history of a sore throat and a fever for three hours The patient had been to Xiaogan City, Hubei Province, and the symptoms occurred during a period of self-isolation after back home The condition of the patient deteriorated rapidly, with left-sided chest and back pain, shortness of breath, dizziness, progressing to respiratory failure and septic shock 7 hours after her admission In view of her critical condition and a history of two previous cesarean sections, an emergency cesarean section was performed Blood gas analysis of the mother before the operation suggested respiratory failure, respiratory acidosis, and metabolic acidosis During the operation, a baby boy was born The Apgar score of the boy, birth weight of 2 700 g, was one at 1, 5, and 10 minutes despite the resuscitation efforts The neonate died after withdrawing treatment The patient was treated with tracheal intubation ventilator and other supportive treatments after the operation The result of the new coronavirus nucleic acid test, taken on admission, but which was reported after delivery, was positive The patient was transferred to the designated hospital for further treatment and was recovering with the withdrawal of extracorporeal membrane oxygenation and ventilation at 26 and 36 days after surgery, respectively Copyright © 2020 by the Chinese Medical Association

S. He

D. Wang

R. Chi

D. Ding

Y. Yu

M. He

W. Li

C. Chi

M. Shi

A critically ill mother with COVID-19 in late pregnancy: a case report

一名妊娠晚期感染COVID-19的危重母亲：病例报告

We present a case of severe COVID-19 in a male newborn A 22-day infant was transferred to Children's Hospital Affiliated to Zhengzhou University due to intermittent fever for 18 The parents of the infant had been living in Wuhan and returned to Xinyang 9 days before delivery Suspecting COVID-19 infection, a cesarean section was performed at 38 gestational weeks The diagnosis of COVID-19 in the mother was confirmed at 2 days postpartum, as well as the father and the grandparents-in-law within 5 days postpartum The baby developed fever and cough 5 days after birth, and a positive result for the new coronavirus nucleic acid test in the pharyngeal swab was shown 6 days after birth The fever continued intermittently for 18 days, whilst nasal catheter oxygen inhalation treatment was administered The percutaneous oxygen saturation decreased to 79% after cessation of oxygen, and the baby was transferred to the hospital for further treatment After admission, the infant presented with cough, occasional choke, shortness of breath despite nasal catheter oxygen inhalation, increased heart rate, low urine volume, and an enlarged liver 2 cm below the right costal margin The baby was diagnosed with severe COVID-19 accompanied by anemia, hyperkalemia, pneumonia, and atrial septal defect seen on the echocardiogram After isolation in an incubator, oxygen inhalation, cardiotonic intervention, blood transfusion and antiviral treatment, the patient made a good recovery, with good breastfeeding, significant resorption of the lung inflammation and no fever or respiratory symptoms The baby was discharged 14 days after hospitalization, with negative results for nucleic acid test of pharyngeal swab for 2 consecutive times Copyright © 2020 by the Chinese Medical Association

Y. Zhang

Y. Cheng

Z. Jin

L. Tan

Z. Yu

S. Luo

Severe COVID-19 in a newborn

新生儿重症 COVID-19

During the COVID-19 epidemic, there have been many misconceptions concerning vertical transmission between the mother and fetus/baby, which has caused much discussion and controversy However, there is no strong evidence to indicate that this novel coronavirus could be vertically transmitted from infected mothers to their fetuses/infants Several easily confused concepts are clarified in this paper, including vertical transmission, intrauterine transmission, mother-to-infant transmission, intrapartum or postpartum transmission Well-designed protocols and a disciplined research team are essential for both basic and clinical research, in order to contribute to obtaining more scientific evidence for better understanding of the characteristics of this novel coronavirus Proper handling and disposal of the body fluids and tissue are critical for safety We highlight the significant value of relevant research, and suggest future research directions, such as investigating the impact of COVID-19 in different trimesters Furthermore, China has the most experience of treating pregnant women exposed to the COVID-19 virus, and it would be a great service to the rest of the world, for all centers in China to collaborate to report this collective experience Copyright © 2020 by the Chinese Medical Association

X. Gao

Y. Zhou

H. Yang

Vertical transmission in COVID-19 pregnant women

COVID-19孕妇的垂直传播

We report a critically ill pregnant woman in the third trimester with severe pneumonia due to COVID-19 who presented to Xiaolan People's Hospital of Zhongshan in February 2020. The 32-year-old patient was admitted at 35 +2 gestational weeks with a 4-day history of a sore throat and a fever for three hours. The patient had been to Xiaogan City, Hubei Province, and the symptoms occurred during a period of self-isolation after back home. The condition of the patient deteriorated rapidly, with left-sided chest and back pain, shortness of breath, dizziness, progressing to respiratory failure and septic shock 7 hours after her admission. In view of her critical condition and a history of two previous cesarean sections, an emergency cesarean section was performed. Blood gas analysis of the mother before the operation suggested respiratory failure, respiratory acidosis, and metabolic acidosis. During the operation, a baby boy was born. The Apgar score of the boy, birth weight of 2 700 g, was one at 1, 5 and 10 minutes despite the resuscitation efforts. The neonate died after withdrawing treatment. The patient was treated with tracheal intubation ventilator and other supportive treatments after the operation. The result of the new coronavirus nucleic acid test, taken on admission, but which was reported after delivery, was positive. The patient was transferred to the designated hospital for further treatment and was recovering with the withdrawal of extracorporeal membrane oxygenation and ventilation support at 26 and 36 days after surgery, respectively.

Shuming He

Dongna Wang

Ruibin Chi

Deliang Ding

Yanping Yu

Minchang He

Weidong Li

Chunxin Chi

Meibin Shi

Death of a neonate born to a critically ill mother with COVID-19: a case report/ 中华围产医学杂志

COVID-19重症母亲所生新生儿死亡病例报告/ 中华围产医学杂志

Wei Song

Zhi Zhang

Shengnan Liang

Xiaoxin Wang

Cuimei Guo

Guanghui Li

Maternal weight gain during pregnancy in obese women and its relationship with adverse pregnancy outcomes

肥胖女性孕期体重增加及其与不良妊娠结局的关系

Publication Information	Publisher: Chinese Medical Journals Publishing House Co.Ltd，Publishing cycle: ，Journal Type: journal，Open Access Journals: No
Basic data	Year of publication: 2020，Proportion of original research papers: 0.00%，Self Citation Rate:N.A.， Gold OA Rate: 0.00%

Chinese Journal of Perinatal Medicine

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Multi-system Langerhans cell histiocytosis in a neonate: a case report and literature review

A critically ill mother with COVID-19 in late pregnancy: a case report

Severe COVID-19 in a newborn

Vertical transmission in COVID-19 pregnant women

Death of a neonate born to a critically ill mother with COVID-19: a case report/ 中华围产医学杂志

Maternal weight gain during pregnancy in obese women and its relationship with adverse pregnancy outcomes

Maternal weight gain during pregnancy in obese women and its relationship with adverse pregnancy outcomes

Maternal weight gain during pregnancy in obese women and its relationship with adverse pregnancy outcomes

Maternal weight gain during pregnancy in obese women and its relationship with adverse pregnancy outcomes

Maternal weight gain during pregnancy in obese women and its relationship with adverse pregnancy outcomes

ISSN	1007-9408
h-index	8