A Multi-Institutional Case Series of Neonatal Lupus Erythematosus Without Cardiac Involvement From Vietnam

Neonatal lupus erythematosus (NLE) is a rare autoimmune disease in newborns and infants, caused by the transplacental transmission of anti-Sjögren's syndrome-related antigen A (anti-SSA), anti-Sjögren's syndrome-related antigen B (anti-SSB), and anti-ribonucleoprotein (anti-RNP) maternal antibodies to fetal tissues during pregnancy, with manifestations in the skin, heart, liver, and hematologic systems. While cardiac abnormalities in NLE, primarily congenital heart block, may be detected prenatally through fetal echocardiography, noncardiac manifestations become evident after birth and can be easily missed due to their nonspecific nature. In this report, we describe six cases of NLE without cardiac involvement, diagnosed and managed by our team across three hospitals in Hanoi, Vietnam, between 2018 and 2023, with patient ages at diagnosis ranging from 40 days to 7 months. Clinical and laboratory findings include skin rash (6/6), anemia (5/6), thrombocytopenia (3/6), neutropenia (3/6), elevated liver enzymes (2/6), hypocomplementemia (4/5), and positivity for anti-SSA (5/6), anti-SSB (4/6), and anti-RNP (2/6) antibodies. Treatment approaches consisted of intravenous immunoglobulin (IVIG) in three cases, oral corticosteroids in one case, topical corticosteroids in one case, and supportive care without specific treatment in one case. All patients demonstrated full clinical recovery without any residual sequelae.