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Neonatal lupus erythematosus

M B Hetem1, M H Takada, M A Llorach Velludo

  • 1Department of Internal Medicine, University of São Paulo, Brazil.

International Journal of Dermatology
|January 1, 1996
PubMed
Summary

Neonatal lupus erythematosus, a rare autoimmune condition, presents with characteristic skin lesions and may be associated with maternal autoantibodies. Early diagnosis and monitoring are crucial for managing this transient condition in infants.

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Area of Science:

  • Dermatology
  • Pediatrics
  • Immunology

Background:

  • Neonatal lupus erythematosus (NLE) is a rare condition caused by transplacental passage of maternal autoantibodies, primarily anti-Ro and anti-La.
  • It typically manifests with cutaneous lesions and may involve cardiac or hepatic systems.

Observation:

  • A newborn girl presented with erythematous-brownish maculae and plaques on the scalp, face, and trunk, exhibiting telangiectasias and atrophy.
  • Histopathology revealed epidermal changes and dermal inflammation with lymphohistiocytic infiltrate.
  • Serologic tests were positive for antinuclear factor (ANF) and anti-Ro antibodies, with HLA-DR3 positivity.

Findings:

  • The infant showed marked improvement in skin lesions by 5 months of age, with serologic markers becoming nonreactive.
  • The mother, though asymptomatic, had positive ANF and anti-Ro antibodies, indicating potential autoimmune predisposition.
  • Maternal serology revealed mild anemia, leukopenia, and thrombocytopenia, alongside positive ANF and anti-Ro antibodies.

Implications:

  • This case highlights the transient nature of NLE skin manifestations and the importance of maternal autoantibody screening.
  • Early identification and supportive care are essential for managing NLE and its potential complications.
  • The association with maternal HLA-DR3 suggests a genetic component in NLE susceptibility.

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