title: Neonatal lupus erythematosus: factors which may lead to clinical disease in the foetus even in the absence of disease in the mother.
abstract: Neonatal lupus erythematosus (NLE) occurs in neonates of mothers who, in almost all cases, have auto-antibodies to the SSA/Ro associated proteins, but who may have no clinical disease. However, only a small percentage of mothers with SSA/Ro antibodies have affected babies, predisposing factors specific to the foetus or neonate (i.e. HLA pattern) and/or fetal maternal interactions have been proposed to be important. We present a mother with a family history of autoimmune disease, but without clinical disease, whose baby developed cutaneous NLE. Autoantibody determinations as well as the HLA-DR/DQ were performed in the mother and baby. Factors other than the HLA-DR/DQ status of the mother appear to be important in determining whether or not the neonate will develop NLE. Auto-antibodies to endogenous antigens common to the mother, transiently expressed developmental antigens, and the isotype specificity of transferred antibodies may be important in determining disease in the baby.
authors.affiliation: Department of Dermatology, National Naval Medical Center, Bethesda, Maryland, USA.
authors.forename: J
authors.initials: J
authors.lastname: Kim
authors.forename: K J
authors.initials: KJ
authors.lastname: Smith
authors.forename: H
authors.initials: H
authors.lastname: Skelton
mesh_terms: D000328:Adult; D005260:Female; D006683:HLA-DQ Antigens / Q000032:analysis; D006684:HLA-DR Antigens / Q000032:analysis; D006801:Humans; D007231:Infant, Newborn; D008178:Lupus Erythematosus, Cutaneous / Q000276:immunology*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000276:immunology*
chemical_list: D006683:HLA-DQ Antigens; D006684:HLA-DR Antigens