title: Autoantibodies in mothers of children with neonatal liver disease.
abstract: OBJECTIVE
  Neonatal lupus erythematosus (NLE) is associated with maternal anti-Ro/La autoantibodies. It is characterized by heart block and/or cutaneous skin lesions, and occasionally liver disease. This study was performed to determine whether idiopathic neonatal cholestasis (INC) represents NLE without its cardiac or cutaneous findings.
  
  
  METHODS
  Sera were obtained for autoantibody analysis from mothers of children with INC (N = 11), biliary atresia (N = 25), other liver disease excluding viral hepatitis (liver disease control subjects, N = 14), and healthy children (normal control subjects [NC], N = 22).
  
  
  RESULTS
  The characteristic serologic findings of NLE, high titer antibodies to Ro and/or La, were absent in mothers from all groups. An unexpected finding was the prevalence of autoantibodies in mothers of infants with liver disease of any type. The frequency of maternal antinuclear antibodies at > or = 1:120 dilution was greater than the estimated frequency in the general population (22% vs. 9%, P = 0.044). The frequency of maternal low titer autoantibodies to 52 kD Ro detected by ELISA was significantly greater than in the NC group (31% vs. 5%, P = 0.014).
  
  
  CONCLUSIONS
  The majority of cases of INC do not represent NLE. The frequent presence of autoantibodies in mothers of infants in all neonatal liver disease groups raises the possibility that maternal serologic autoimmunity is associated with neonatal liver disease.
authors.affiliation: Department of Dermatology, University of Colorado School of Medicine, CO, USA.
authors.forename: Joanna M
authors.initials: JM
authors.lastname: Burch
authors.forename: Ronald J
authors.initials: RJ
authors.lastname: Sokol
authors.forename: Michael R
authors.initials: MR
authors.lastname: Narkewicz
authors.forename: Morris
authors.initials: M
authors.lastname: Reichlin
authors.forename: Mark Barton
authors.initials: MB
authors.lastname: Frank
authors.forename: Todd
authors.initials: T
authors.lastname: MacKenzie
authors.forename: Lela A
authors.initials: LA
authors.lastname: Lee
mesh_terms: D000328:Adult; D000974:Antibodies, Antinuclear / Q000032:analysis / Q000097:blood; D001323:Autoantibodies / Q000032:analysis / Q000097:blood*; D001656:Biliary Atresia / Q000097:blood / Q000276:immunology*; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D002779:Cholestasis / Q000097:blood / Q000276:immunology*; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D007112:Immunity, Maternally-Acquired; D007223:Infant; D007231:Infant, Newborn; D008107:Liver Diseases / Q000097:blood / Q000276:immunology; D008178:Lupus Erythematosus, Cutaneous / Q000097:blood / Q000276:immunology*; D011247:Pregnancy
chemical_list: D000974:Antibodies, Antinuclear; D001323:Autoantibodies; C035356:SS-A antibodies; C035357:SS-B antibodies