Neonatal lupus erythematosus

Neonatal lupus erythematosus (NLE) is an acquired autoimmune disorder caused by transplacental passage of maternal immunoglobulin G (IgG) autoantibodies, predominantly Sjögren syndrome antigens A (Ro/SSA) and B (La/SSB), leading to clinical manifestations in the neonate.

It occurs in approximately 1 in 12,500-20,000 live births. The incidence rate is about 2% among infants born to mothers with anti-Ro/SSA or anti-La/SSB antibodies, with an 18% to 20% recurrence risk in subsequent pregnancies. These autoantibodies are present in 0.1% to 1.5% of healthy pregnant women and are common in autoimmune diseases - detected in up to 90% of patients with Sjögren syndrome, 20% to 30% with SLE, and 3% to 4% with rheumatoid arthritis.

Most of these children have complete heart block. Immunoglobulin and complement can be demonstrated in affected hearts.

In neonatal lupus the rash disappears after approximately the half life of the maternal immunoglobulin G. Generally the rash is gone after 6 months.

Reference:

1. Vanoni F et al. Neonatal Systemic Lupus Erythematosus Syndrome: a Comprehensive Review. Clin Rev Allergy Immunol. 2017 Dec;53(3):469-476.