Maternal Sjögren's Presenting as Neonatal Lupus

March 13, 2014

In some cases, like this one, a woman's first manifestation of autoimmune disease arises in her newborn infant.

Khaleeland M and Puliyel M. Images in Clinical Medicine: Neonatal Lupus. N Engl J Med. (2014) 370:958. March 6, 2014. DOI: 10.1056/NEJMicm1307809

Mothers with only mild or no symptoms of autoimmune disease may be at substantial risk for an overt autoimmune disorder, most commonly Sjögren’s syndrome or systematic lupus erythematosus (SLE). The first clinical manifestation may affect the child, in the form of neonatal lupus, as maternal antibodies cross the placenta.

In this image-based case report, a baby boy born to apparently healthy parents had a bright red rash over his face within two hours after birth. Serological testing of the infant was positive for SSA (Ro) and SSB (La), confirming the diagnosis of neonatal lupus. The rash resolved within six months after birth.

The child’s mother had not been diagnosed with an autoimmune disease, but had had dry eyes for more than a year, which required artificial tears. She was subsequently diagnosed with Sjögren’s syndrome.