Late neonatal lupus erythematosus onset in a child born of a mother with primary Sjögren's syndrome.
BACKGROUND
The neonatal lupus syndrome can be present as congenital heart block (CHB) or as neonatal lupus erythematosus (NLE), both seldom passively acquired autoimmune diseases. CHB starts around week 20 of pregnancy and is a lifelong event, whereas NLE is self limiting and usually starts at the 6th week of the child's age-the maximum recorded up to week 20.


METHODS
An asymptomatic mother with primary Sjogren's syndrome and anti-SSA/Ro52, anti-SSA/Ro60, and anti-SSB/La autoantibodies is described who, at gestational week 23 during her first pregnancy, was diagnosed as having a male fetus with CHB due to third degree atrioventricular block. The boy from the second pregnancy developed skin eruptions which clinically and by biopsy were compatible with NLE at week 20+1 post partum.


CONCLUSIONS
Our case of NLE, starting at week 20+1 of age, seems to be the latest reported clinical case of NLE. Development of CHB and NLE in two consecutive boy pregnancies is unusual.
Sjögren's Syndrome Research Centre in Malmö, Jägersrovägen 80, SE-212 37 Malmö, Sweden. Manthorpe@inet.uni2.dk
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R
Manthorpe
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A
Svensson
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LE
Wirestrand
D017668:Age of Onset; D016241:Child of Impaired Parents; D005260:Female; D005313:Fetal Death; D006327:Heart Block / Q000196:embryology; D006801:Humans; D007231:Infant, Newborn; D008180:Lupus Erythematosus, Systemic / Q000276:immunology*; D008297:Male; D008431:Maternal-Fetal Exchange; D011247:Pregnancy; D011248:Pregnancy Complications; D011263:Pregnancy Trimester, Third; D012859:Sjogren's Syndrome