[Neonatal cutaneous lupus. Necessary interdisciplinary collaboration].
BACKGROUND
Neonatal lupus erythematosus is a rare syndrome (affecting 5% of the children born of mothers with lupus), characterized essentially by cutaneous lesions and/or congenital auricular-ventricular heart block. It is due to the transplacental passage of maternal antibodies (anti-SSA or anti-SSB, or occasionally anti-U1RNP antibodies) into the fetal circulation.


METHODS
We report a case of neonatal lupus erythematosus, having appeared 4 weeks after birth. The 26 years old mother exhibited systemic lupus erythematosus concomitant to Gougerot-Sjögren's syndrome, with positive antinuclear factors (1/2560), native anti-DNA, anti-SSA and anti-SSB antibodies and anticardiolipin antibodies. During pregnancy, the mother had been treated with aspirin at the dose of 100 mg/day, followed by subcutaneous enoxaparin 0.4 ml/day, and combined with prednisone 10 mg/d and hydroxychloroquine 400 mg/day. Early and regular cardiac monitoring of the foetus was performed. The clinical examination and the electrocardiogram at birth were normal. Four weeks later, the infant presented with erythematous cutaneous lesions with atrophic center. No systemic treatment was initiated and the lesions partially regressed.


CONCLUSIONS
Cutaneous lesions can also appear after the 4th week of life. It is important that the pediatricians clinically monitor all the children born to mothers exhibiting anti-SSA or anti-SSB antibodies, at least during the first 7 months of life.
Stirnemann
J
J
Service de médecine interne, AP-HP, Université Paris-Nord, UPRES EA 3409, Hôpital Jean Verdier, Avenue du 14 juillet 93143 Bondy. jerome.stirnemann@jvr.ap-hop-paris.fr
Fain
O
O
Lachassinne
E
E
Levet
R
R
Carbillon
L
L
Kettaneh
A
A
Aurousseau
M H
MH
Uzan
M
M
Thomas
M
M
D000328:Adult; D001323:Autoantibodies / Q000097:blood; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D006327:Heart Block / Q000151:congenital / Q000175:diagnosis / Q000276:immunology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008178:Lupus Erythematosus, Cutaneous / Q000151:congenital* / Q000175:diagnosis / Q000276:immunology; D008180:Lupus Erythematosus, Systemic / Q000175:diagnosis* / Q000276:immunology; D008431:Maternal-Fetal Exchange / Q000276:immunology; D010348:Patient Care Team; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis* / Q000276:immunology; D011296:Prenatal Diagnosis; D012075:Remission, Spontaneous
D001323:Autoantibodies