Neonatal lupus erythematosus, late onset hypocalcaemia, and recurrent seizures

Area of Science:

• Neonatal immunology
• Pediatric neurology
• Maternal-fetal medicine

Background:

• Neonatal lupus erythematosus (NLE) is a rare condition where maternal autoantibodies cross the placenta.
• Maternal autoantibodies, typically anti-Ro/SSA and anti-La/SSB, can affect the fetus, leading to various clinical manifestations.

Observation:

• A 6-day-old infant presented with NLE, exhibiting a characteristic rash, hemolytic anemia, and hepatosplenomegaly.
• The infant's mother was asymptomatic during pregnancy until the third trimester.
• Between 7 and 10 weeks of age, the infant experienced recurrent seizures attributed to hypocalcemia, with other causes ruled out.

Findings:

• The infant's NLE symptoms, including hematologic and hepatic abnormalities, showed significant improvement by 14 weeks of age.
• The seizures and hypocalcemia, a less common manifestation of NLE, also resolved spontaneously.
• This case demonstrates the potential for transient and self-limiting symptoms in NLE.

Implications:

• This case underscores the importance of recognizing NLE's diverse clinical spectrum, including neurological complications like seizures.
• The transient nature of these abnormalities suggests a potential for favorable outcomes with supportive care.
• Further research into the immunopathogenesis of NLE and its neurological manifestations is warranted.