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[Neonatal cutaneous lupus. Necessary interdisciplinary collaboration].

J Stirnemann1, O Fain, E Lachassinne

  • 1Service de médecine interne, AP-HP, Université Paris-Nord, UPRES EA 3409, Hôpital Jean Verdier, Avenue du 14 juillet 93143 Bondy. jerome.stirnemann@jvr.ap-hop-paris.fr

Presse Medicale (Paris, France : 1983)
|October 16, 2002
PubMed
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Neonatal lupus erythematosus can manifest with skin lesions appearing weeks after birth. Pediatricians should monitor infants of mothers with lupus for these symptoms, especially those with anti-SSA or anti-SSB antibodies.

Area of Science:

  • Neonatal immunology
  • Autoimmune disorders in pregnancy
  • Pediatric dermatology

Background:

  • Neonatal lupus erythematosus (NLE) is a rare condition affecting infants born to mothers with autoimmune diseases like lupus.
  • It is caused by the transplacental transfer of maternal autoantibodies, primarily anti-SSA/Ro and anti-SSB/La.
  • NLE classically presents with skin lesions and/or congenital heart block.

Observation:

  • A case of NLE is presented in an infant whose mother has systemic lupus erythematosus and Gougerot-Sjögren's syndrome.
  • The mother had a history of positive antinuclear, anti-DNA, anti-SSA, anti-SSB, and anticardiolipin antibodies.
  • The infant developed erythematous cutaneous lesions with atrophic centers four weeks after birth, despite prenatal monitoring and treatment.

Findings:

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  • Cutaneous lesions in neonatal lupus erythematosus can emerge as late as four weeks after birth.
  • The infant's lesions showed partial regression without systemic treatment.
  • Congenital heart block was not observed in this case, but skin manifestations were present.

Implications:

  • Pediatricians must maintain clinical vigilance for NLE symptoms in infants born to mothers with anti-SSA or anti-SSB antibodies.
  • Extended monitoring, at least through the first seven months of life, is crucial for early detection and management.
  • This case highlights the variable timing of NLE symptom onset and the importance of continued observation.