When should a neonatologist consult a rheumatologist?

Area of Science:

• Pediatric Rheumatology
• Neonatal Medicine
• Autoimmune Diseases

Background:

• Neonatal rheumatologic diseases are complex, affecting multiple organ systems in infants 0-18 years.
• Diagnosis is challenging due to nonspecific symptoms overlapping with other neonatal conditions.
• Maternal autoimmune diseases and treatments can impact neonatal health, increasing risks like thrombosis.

Purpose of the Study:

• To review rheumatologic diseases in neonates, including primary neonatal-onset conditions and those influenced by maternal factors.
• To highlight diagnostic challenges and the importance of early identification and care.
• To discuss the role of maternal autoimmune diseases and treatments in neonatal health.

Main Methods:

• Literature review focusing on pediatric rheumatologic diseases in neonates.
• Analysis of primary neonatal-onset conditions and maternal influences.
• Discussion of diagnostic complexities and management strategies.

Main Results:

• Primary neonatal-onset diseases (e.g., CAPS, DIRA, neonatal-onset JIA) are rare but significant.
• Maternal SLE and APS increase neonatal risks, potentially causing thrombosis or pregnancy loss.
• Novel biomarkers are emerging for diagnosing conditions like cardiac neonatal lupus.

Conclusions:

• Persistent fever, rash, or joint issues in neonates require prompt pediatric rheumatologist referral.
• A collaborative approach involving obstetricians, rheumatologists, and neonatologists ensures optimal neonatal outcomes.