Neonatal lupus erythematosus

Neonatal lupus erythematosus (NLE) is a rare autoimmune disease that affects newborns. It is caused by the transplacental passage of maternal autoantibodies to the fetus. The most common clinical manifestations are skin rash, heart block, and hematological abnormalities.

Etiology

NLE is caused by the passage of maternal autoantibodies, specifically anti-Ro/SSA and anti-La/SSB, across the placenta to the fetus. These antibodies are found in mothers with autoimmune diseases such as SLE and Sjögren's syndrome. However, some mothers of infants with NLE do not have any symptoms of these diseases.

Clinical Manifestations

The most common clinical manifestations of NLE are:

• Skin rash: This is often the first sign of NLE. It usually appears within the first few weeks of life and resolves within six months. The rash is typically annular and erythematous, and is most commonly found on the face and scalp.

• Heart block: This is a serious complication of NLE and can lead to death. It is usually detected in utero and is irreversible.

• Hematological abnormalities: These can include thrombocytopenia, neutropenia, and anemia.

Diagnosis

The diagnosis of NLE is based on clinical findings and the presence of maternal autoantibodies. Skin biopsy can be used to confirm the diagnosis.

Treatment

There is no specific treatment for NLE. Management is supportive and includes sun protection for the skin rash and pacemaker implantation for heart block.

Prognosis

The prognosis for NLE is generally good. The skin rash and hematological abnormalities usually resolve within six months. However, heart block is a serious complication and can lead to death.

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