Neonatal lupus erythrematosus
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Synonyms and keywords:; NL, neonatal lupus
Overview
Neonatal lupus (NL) is an autoimmune disease of neonates that results from passive transfer of autoantibodies from the mother to the fetus. It occurs in about 1 to 2 percent of babies born to mothers with autoimmune disease, primarily systemic lupus erythematosus (SLE) and Sjögren’s syndrome, and antibodies to SSA/Ro and/or SSB/La.[1][2]. It is characterized by cutaneous, cardiac or rarely both clinical manifestations.
Historical Perspective
Classification
Pathophysiology
Neonatal lupus (NL) is presumed to result from transplacental passage of maternal anti-SSA/Ro and/or anti-SSB/La antibodies. The precise mechanism of injury to specific tissues, such as the skin and heart, is not known. In addition to the traditional Ro antigen of 60kD, another antigen of 52kD has been identified. Whether this second antigen is really “Ro” remains controversial since the Ro52 does not contain an RNA binding domain. Antibodies with a specificity for the 52 kD component of the SSA/Ro protein (Ro52) are more frequently found and are present at higher concentrations in the serum of children with congenital heart block (CHB) and their mothers.[3][4][5]
Genetics
Associated Conditions
Gross Pathology
Microscopic Pathology
Causes
Life Threatening Causes
Life-threatening causes include conditions which may result in death or permanent disability within 24 hours if left untreated.
Common Causes
Causes by Organ System
| Cardiovascular | No underlying causes |
| Chemical / poisoning | No underlying causes |
| Dermatologic | No underlying causes |
| Drug Side Effect | No underlying causes |
| Ear Nose Throat | No underlying causes |
| Endocrine | No underlying causes |
| Environmental | No underlying causes |
| Gastroenterologic | No underlying causes |
| Genetic | No underlying causes |
| Hematologic | No underlying causes |
| Iatrogenic | No underlying causes |
| Infectious Disease | No underlying causes |
| Musculoskeletal / Ortho | No underlying causes |
| Neurologic | No underlying causes |
| Nutritional / Metabolic | No underlying causes |
| Obstetric/Gynecologic | No underlying causes |
| Oncologic | No underlying causes |
| Opthalmologic | No underlying causes |
| Overdose / Toxicity | No underlying causes |
| Psychiatric | No underlying causes |
| Pulmonary | No underlying causes |
| Renal / Electrolyte | No underlying causes |
| Rheum / Immune / Allergy | No underlying causes |
| Sexual | No underlying causes |
| Trauma | No underlying causes |
| Urologic | No underlying causes |
| Dental | No underlying causes |
| Miscellaneous | No underlying causes |
Causes in Alphabetical Order
- A...
- Z...
Make sure that each diagnosis is linked to a page.
Differentiating type page name here from other Diseases
Epidemiology and Demographics
Age
Gender
Race
Developed Countries
Developing Countries
Risk Factors
Screening
Natural History, Complications and Prognosis
Diagnosis
History
A directed history should be obtained to ascertain
Symptoms
"Type symptom here" is pathognomonic of the "type disease name here".
"Type non specific symptoms" may be present.
Past Medical History
Family History
Social History
Occupational
Alcohol
The frequency and amount of alcohol consumption should be characterized.
Drug Use
Smoking
Allergies
Physical Examination
Appearance of the Patient
Vital Signs
Skin
Head
Eyes
Ear
Nose
Mouth
Throat
Heart
Lungs
Abdomen
Extremities
Neurologic
Genitals
Other
Laboratory Findings
Electrolyte and Biomarker Studies
Electrocardiogram
Chest X Ray
CT
MRI
Echocardiography or Ultrasound
Other Imaging Findings
Other Diagnostic Studies
Treatment
Pharmacotherapy
Acute Pharmacotherapies
Chronic Pharmacotherapies
Surgery and Device Based Therapy
Indications for Surgery
Pre-Operative Assessment
Post-Operative Management
Transplantation
Primary Prevention
Secondary Prevention
Cost-Effectiveness of Therapy
Future or Investigational Therapies
References
- ↑ Brucato A, Cimaz R, Caporali R, Ramoni V, Buyon J (2011). "Pregnancy outcomes in patients with autoimmune diseases and anti-Ro/SSA antibodies". Clin Rev Allergy Immunol. 40 (1): 27–41. doi:10.1007/s12016-009-8190-6. PMC 3558034. PMID 20012231.
- ↑ Buyon JP (2009). "Updates on lupus and pregnancy". Bull NYU Hosp Jt Dis. 67 (3): 271–5. PMID 19852749.
- ↑ Buyon JP, Winchester RJ, Slade SG, Arnett F, Copel J, Friedman D; et al. (1993). "Identification of mothers at risk for congenital heart block and other neonatal lupus syndromes in their children. Comparison of enzyme-linked immunosorbent assay and immunoblot for measurement of anti-SS-A/Ro and anti-SS-B/La antibodies". Arthritis Rheum. 36 (9): 1263–73. PMID 8216420.
- ↑ Silverman ED, Buyon J, Laxer RM, Hamilton R, Bini P, Chu JL; et al. (1995). "Autoantibody response to the Ro/La particle may predict outcome in neonatal lupus erythematosus". Clin Exp Immunol. 100 (3): 499–505. PMC 1534456. PMID 7774062.
- ↑ Salomonsson S, Dörner T, Theander E, Bremme K, Larsson P, Wahren-Herlenius M (2002). "A serologic marker for fetal risk of congenital heart block". Arthritis Rheum. 46 (5): 1233–41. doi:10.1002/art.10232. PMID 12115229.