Neonatal lupus is an uncommon autoimmune disease

Neonatal lupus is an uncommon autoimmune disease manifested primarily by cutaneous lupus lesions and/or congenital heart block.

It is associated with anti-SSA/Ro and/or anti-SSB/La antibodies from the mother that affect the fetus.

๐ŸŸขSYMPTOMS

The most common symptom associated with neonatal lupus is a rash that consists of reddish, ring-like skin lesions and resembles the rash associated with systemic lupus erythematosus. The rash is temporary (transient), usually developing during the first few weeks of life and clearing up at some point during the next several months. In rare cases, skin lesions may persist into childhood.

๐Ÿ”บSpectacle like rash is characteristics

๐Ÿ”บAnemia

๐Ÿ”บThrombocytopenia

๐Ÿ”บHepatitis can also occur

๐Ÿ›‘The most serious complication of neonatal lupus is a heart condition known as congenital heart block which is permanent and needs pacemaker. it is mostly associated with anti To antibodies.

๐Ÿ”ตCAUSE

Neonatal lupus is a rare acquired disorder that occurs when specific antibodies are passed from a pregnant woman to the developing fetus via the placenta. In most cases, it is the anti-Ro/SSA antibody, the anti-La/SSB antibody, or both

Mothers of infants with neonatal lupus do not necessarily have lupus themselves. Women who have the anti-Ro or anti-La antibodies may have a different rheumatic disorder such as Sjogrenโ€™s syndrome or rheumatoid arthritis. In many cases, women with these antibodies may not have any symptoms of rheumatic disease (asymptomatic) or only vague symptoms such as photosensitivity or color changes of their fingers in cold weather (Raynauds) suggesting rheumatic disease or may be diagnosed with an autoimmune disorder only after a diagnosis of neonatal lupus in their child

DIAGNOSIS AND INVESTIGATIONS

The diagnosis is usually established based on the clinical features and the demonstration of NLE-associated antibodies in the serum of the mother or the affected infant

๐Ÿ”บNLE is associated with the anti-Ro/SSA antibody in more than 90% of patients. Occasionally, patients only have anti-La/SSB or anti-U1RNP antibodies. Screening of infants with NLE for the presence of these antibodies is strongly recommended. Many asymptomatic mothers have positive putative antibodies during pregnancy

๐Ÿ”บPrenatal ultrasonography may help identify NLE that affects the heart. Echocardiography may reveal various types of structural deformities in the heart; combined electrocardiography and 24-hour Holter monitoring may reveal various cardiac conduction disorders or different types of heart blocks.

๐ŸŸ TREATMENT

Cutaneous symptoms generally resolve without treatment (spontaneously) during the first several months of life.

Protection from sunlight (e.g. sunscreen and protective clothing) is recommended for infants initially

CHB requires pacemaker placement.