De novo production of IgG antinuclear antibodies in a neonate.
We describe the first case in which de novo production of multiple IgG antinuclear antibodies (ANA) occurred in a female neonate of an ANA negative mother. The infant presented at 4 weeks of age with hemorrhagic panencephalitis, diffuse intraparenchymal hemorrhages, and straight sinus thrombosis. She had been vaccinated against hepatitis B at birth. No other cause was found and maternal prenatal care was unremarkable. The infant's screening ANA test by ELISA was positive at 6 weeks with specificity for ssDNA, Sm, and nRNP/Sm. At 8 weeks antibodies to dsDNA and centromere were detected as well. By 8 months, she still had slightly elevated anti-dsDNA, Sm, and nRNP/Sm antibodies. The ANA test by immunofluorescence was abnormal at 8 weeks through 13 weeks with centromere and then homogeneous pattern. Based on similarities with other reported cases, we speculate that hepatitis B vaccination may have been involved in the development of antinuclear antibodies.
Kapogiannis
B G
BG
Department of Pediatrics, University of Illinois College of Medicine, Chicago 60612, USA.
Gussin
H A
HA
Teodorescu
M
M
D000328:Adult; D000974:Antibodies, Antinuclear / Q000276:immunology*; D001324:Autoantigens / Q000276:immunology; D002503:Centromere / Q000276:immunology; D004247:DNA / Q000276:immunology; D004277:DNA, Single-Stranded / Q000276:immunology; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000032:analysis*; D007231:Infant, Newborn; D012016:Reference Values; D017411:Ribonucleoproteins, Small Nuclear; D012851:Sinus Thrombosis, Intracranial / Q000150:complications / Q000276:immunology / Q000473:pathology; D013344:Subacute Sclerosing Panencephalitis / Q000150:complications / Q000276:immunology / Q000473:pathology; D055517:snRNP Core Proteins
D000974:Antibodies, Antinuclear; D001324:Autoantigens; D004277:DNA, Single-Stranded; D007074:Immunoglobulin G; D017411:Ribonucleoproteins, Small Nuclear; D055517:snRNP Core Proteins; D004247:DNA