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When should a neonatologist consult a rheumatologist?

Ali Öksel1, Nihal Şahin2, Ayla Günlemez3

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Neonatal rheumatologic diseases present with nonspecific symptoms, making diagnosis challenging. Early referral and a multidisciplinary approach are vital for managing these complex pediatric conditions and improving outcomes.

Keywords:
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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.