Early cholestasis in neonatal lupus erythematosus.
Neonatal lupus erythematosus is an immune-mediated disease caused by transplacental passage of maternal autoantibodies, primarily anti-Ro (SSA) and anti-La (SSB). The major clinical manifestations are congenital heart block, cutaneous lupus lesions, and hematologic problems. Hepatic, pulmonary, and neurological involvements are rare. We report a 5-day-old male neonate, born to a clinically asymptomatic mother, presenting with conjugated hyperbilirubinemia, cutaneous lupus lesions, congenital heart block, and thrombocytopenia. Both the neonate and his mother had high titers of antinuclear antibodies (1:640), anti-Ro (SSA), and anti-La (SSB) antibodies. The thrombocytopenia improved with prednisolone (2 mg/kg/day) for 14 days. The skin lupus rashes and bilirubin resolved 2 months later, and liver enzymes were completely normal by 6 months.
Shahian
Mozhgan
M
Division of Neonatology, Department of Pediatrics, Shiraz University of Medical Sciences, Shiraz, Iran.
Khosravi
Amir
A
Anbardar
Mohammad-Hossein
MH
D001323:Autoantibodies / Q000097:blood; D002779:Cholestasis / Q000150:complications*; D005938:Glucocorticoids / Q000627:therapeutic use; D006327:Heart Block / Q000150:complications / Q000151:congenital; D006801:Humans; D006932:Hyperbilirubinemia / Q000150:complications; D007231:Infant, Newborn; D008178:Lupus Erythematosus, Cutaneous / Q000150:complications* / Q000175:diagnosis / Q000276:immunology; D008297:Male; D011239:Prednisolone / Q000627:therapeutic use; D012698:Serologic Tests; D013921:Thrombocytopenia / Q000150:complications / Q000188:drug therapy
D001323:Autoantibodies; D005938:Glucocorticoids; D011239:Prednisolone