Possible discoid lupus erythematosus in newborn infant. Report of a case with subsequent development of acute systemic lupus erythematosus in mother

Abstract

Cases of a newborn infant with an eruption clinically and histologically consistent with lupus erythematosus and of his mother developing acute disseminate lupus erythematosus 11 months after delivery are presented. It is urged that in the future in cases of death of a fetus of a mother who has lupus erythematosus of any type or who gives a history of this disease, the fetus be examined for stigmata of lupus erythematosus. The possibility of a transmittable etiological agent of lupus erythematosus from mother to fetus is suggested.

Significance of Autoantibodies in Neonatal Lupus Erythematosus

“…While isolated congenital heart block (CHB), as one of the clinical syndromes, has been described in 1901 [1] for the very first time, associated maternal diseases became apparent in 1928 [2] and 1954 [3], respectively. Finally, the typical association of maternal antibodies to Ro(SS-A) has been described for CHB in 1983 [4,5], whereas another syndrome, cutaneous NLE, has been described in 1981 [6,7] (table 1).…”

Lupus eritematoso neonatal: reporte de cuatro casos

“…It is a rare disease that affects approximately 1 in every 20,000 live-born infants, principally girls (65%), 5 although this trend was not seen in the 3,7,12 The mortality rate in infants with congenital heart block (CHB) is around 20% even with implantation of a pacemaker, a procedure that is required in 50-100% of cases. 4,6,[11][12][13] The risk of heart involvement in the firstborn child of an anti-Ro-positive mother is 1-2% and occurrence of the same disorder in a second child is 18%. 14 The efficacy of intravenous immunoglobulin is currently being evaluated for the prophylactic treatment of CHB in high-risk pregnancies (mothers who already have children with NLE) and it is recommended that fetal echocardiography should be performed from the sixteenth week of pregnancy onwards in all anti-Ropositive mothers.…”

“…Histopathology of the skin is compatible with subacute cutaneous lupus, 11 although in general this is not necessary for confirmation of diagnosis. 13 The prognosis of the disease is defined by the cardiac involvement, since most of the other manifestations are transitory and self-resolving. Long-term follow-up is vital in these patients, since they are at an increased risk of developing autoimmune diseases in late childhood or adulthood.…”

Neonatal Lupus Erythematosus in South Korea: Clinical and Serologic Features

“…Discussion NLE, a rare disease whose true incidence has not yet been determined because of the suspected high rate of undiagnosed incidence, is primarily characterized by clinical manifestation of transient cutaneous lesions, isolated CHB, or both and associated with a variety of systemic manifestations (Table 3). NLE was first described by McCuiston and Schoch in a case report of an infant with transient lupus skin lesions whose mother was found to be ANA-positive [1]. The first case of NLE in South Korea was reported in 1993 [3].…”

“…Neonatal lupus erythematosus (NLE) is a rare disorder first described by McCuiston and Schoch [1]. Based on the finding that more than 95% of infants with NLE test positive for anti-Ro/(SS-A) and/or anti-La/ (SS-B) antibodies, the route of NLE transmission is hypothesized to be transplacental passage of maternal antibodies, especially anti-Ro/(SS-A) and/or anti-La/(SS-B) antibodies.…”