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...

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Bibliographic Details
Published in:Annals of Saudi medicine 2011-01, Vol.31 (1), p.80-82
Main Authors: Shahian, Mozhgan, Khosravi, Amir, Anbardar, Mohammad-Hossein
Format: Article
Language:English
Subjects:
Autoantibodies - blood
Autoimmune diseases
Case Report
Case studies
Cholestasis
Cholestasis - complications
Complications and side effects
Corticosteroids
Diagnosis
Drug therapy
Gallbladder diseases
Glucocorticoids - therapeutic use
Health aspects
Heart Block - complications
Heart Block - congenital
Humans
Hyperbilirubinemia - complications
Infant, Newborn
Jaundice, Obstructive
Liver cirrhosis
Lupus
Lupus Erythematosus, Cutaneous - complications
Lupus Erythematosus, Cutaneous - diagnosis
Lupus Erythematosus, Cutaneous - immunology
Male
Metabolic disorders
Patient outcomes
Prednisolone - therapeutic use
Risk factors
Serologic Tests
Systemic lupus erythematosus
Thrombocytopenia - complications
Thrombocytopenia - drug therapy
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Summary: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.
ISSN:0256-4947
0975-4466
DOI:10.4103/0256-4947.70569