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Neonatal lupus erythematosus – practical guidelines

  • Julia Marta Derdulska ORCID logo , Lidia Rudnicka ORCID logo EMAIL logo , Agata Szykut-Badaczewska ORCID logo , Dorota Mehrholz ORCID logo , Roman J. Nowicki ORCID logo , Wioletta Barańska-Rybak ORCID logo and Aleksandra Wilkowska ORCID logo
Published/Copyright: January 18, 2021

Abstract

Background

Neonatal lupus erythematosus is an autoimmune disease acquired during fetal life as a result of transplacental passage of maternal anti-Sjögren’s-syndrome-related antigen A (anti-SSA/Ro), anti-Sjögren’s-syndrome-related antigen B (anti-SSB/La) or anti-U1 ribonucleoprotein (anti-U1-RNP) antinuclear autoantibodies.

Contents

Clinical manifestations include skin lesions, congenital heart block, hepatobiliary involvement and cytopenias. Most of the disorders disappear spontaneously after clearance of maternal antibodies. Cardiac symptoms, however, are not self-resolving and often pacemaker implantation is required. Diagnosis is based on clinical presentation and the presence of typical antibodies in the mother’s or infant’s serum.

Outlook

Neonatal lupus erythematosus may develop in children born to anti-SSA/Ro or anti-SSB/La women with various systemic connective tissue diseases. However, in half of the cases, the mother is asymptomatic, which may delay the diagnosis and have negative impact on the child’s prognosis. Testing for antinuclear antibodies should be considered in every pregnant woman since early treatment with hydroxychloroquine or intravenous immunoglobulin (IVIG) has proven to be effective in preventing congenital heart block.


Corresponding author: Professor Lidia Rudnicka, MD, PhD, Department of Dermatology, Medical University of Warsaw, Koszykowa 82A 02-008Warsaw, Poland, Phone: +48 22 502 13 24, E-mail:

  1. Research funding: None declared.

  2. Author contributions: All authors have accepted responsibility for the entire content of this manuscript and approved its submission.

  3. Competing interests: Authors state no conflict of interest.

  4. Ethical approval: Not applicable.

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Received: 2020-07-24
Accepted: 2020-12-11
Published Online: 2021-01-18
Published in Print: 2021-06-25

© 2021 Walter de Gruyter GmbH, Berlin/Boston

Articles in the same Issue

  1. Frontmatter
  2. Review
  3. Neonatal lupus erythematosus – practical guidelines
  4. Original Articles – Obstetrics
  5. Optimal timing to screen for asymptomatic bacteriuria during pregnancy: first vs. second trimester
  6. Amniotic fluid embolism – implementation of international diagnosis criteria and subsequent pregnancy recurrence risk
  7. COL1A1, COL4A3, TIMP2 and TGFB1 polymorphisms in cervical insufficiency
  8. Pregnancy and neonatal outcomes of twin pregnancies – the role of maternal age
  9. Comparison of maternal third trimester hemodynamics between singleton pregnancy and twin pregnancy
  10. Daily monitoring of vaginal interleukin 6 as a predictor of intraamniotic inflammation after preterm premature rupture of membranes – a new method of sampling studied in a prospective multicenter trial
  11. Association between the number of pulls and adverse neonatal/maternal outcomes in vacuum-assisted delivery
  12. Original Articles – Fetus
  13. The effect of nuchal umbilical cord on fetal cardiac and cerebral circulation-cross-sectional study
  14. Recognition of facial expression of fetuses by artificial intelligence (AI)
  15. Correlation of first-trimester thymus size with chromosomal anomalies
  16. Fetal intracranial structures: differences in size according to sex
  17. Original Articles – Neonates
  18. Antenatal care and perinatal outcomes of asylum seeking women and their infants
  19. Maturation of the cardiac autonomic regulation system, as function of gestational age in a cohort of low risk preterm infants born between 28 and 32 weeks of gestation
  20. Short Communication
  21. The impact of transfers from neonatal intensive care to paediatric intensive care
  22. Letter to the Editor
  23. Differential microRNA expression in placentas of small-for-gestational age neonates with and without exposure to poor maternal gestational weight gain
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