Abstract
Neonatal lupus erythematosus (NLE) is a rare, passively acquired autoimmune disease, caused by maternal autoantibodies. Characteristic clinical features of NLE are transient rash and congenital heart block (CHB), but also hematological abnormalities and hepatobiliary dysfunction may occur. Complications to the transient dermatitis are rarely described. We describe two patients with NLE and cutaneous manifestations. Both patients had involvement of the sun-protected genital skin and soles. New manifestations of NLE were gastrointestinal bleeding in one patient despite normal coagulation parameters, but with mucosal telangiectatic lesions found on sigmoidoscopy. In addition, one patient developed painful atrophy after plantar dermatitis on follow-up with need of orthopedic footwear. CHB was not found. In conclusion, NLE may be complicated with sigmoidal telangiectasia with rectal bleeding and painful plantar atrophy.
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Askanase AD, Izmirly PM, Katholi M, Mumtaz J, Buyon JP (2010) Frequency of neuro-psychiatric dysfunction in anti-SSA/SSB exposed children with and without neonatal lupus. Lupus 19:300–306
Cimaz R, Spence DL, Hornberger L, Silverman ED (2003) Incidence and spectrum of neonatal lupus erythematosus: a prospective study of infants born to mothers with anti-Ro autoantibodies. J Pediatr 142:678–683
Friedman DM, Rupel A, Buyon JP (2007) Epidemiology, etiology, detection and treatment of autoantibody-associated congenital heart block in neonatal lupus. Curr Rheumatol Rep 9:101–108
Furukawa F, Lyons MB, Lee LA, Coulter SN, Norris DA (1988) Estradiol enhances binding to cultured human keratinocytes of antibodies specific for SS-A/Ro and SS-B/LA. Another possible mechanism for estradiol influence of lupus erythematosus. J Immunol 141:1480–1488
Gordon PA (2007) Congenital heart block: clinical features and therapeutic approaches. Lupus 16:642–646
Izmirly PM, Llanos C, Lee LA, Askanase A, Kim MY, Buyon JP (2010) Cutaneous manifestations of neonatal lupus and risk of subsequent congenital heart block. Arthritis Rheum 62(4):1153–1157
Korkij W, Soltani K (1984) Neonatal lupus erythematosus: a review. Pediatr Dermatol 1:189–195
Lee LA (2004) Neonatal lupus: clinical features and management. Paediatr Drugs 6:71–78
Lee LA (1993) Neonatal lupus erythematosus. J Invest Dermatol 100:9–13
Martin V, Lee LA, Askanase AD, Katholi M, Buyon JP (2002) Long-term follow-up of children with neonatal lupus and their unaffected siblings. Arthritis Rheum 46:2377–2383
Nadorra RL, Nakazato Y, Landing BH (1987) Pathologic features of gastrointestinal tract lesions in childhood-onset systemic lupus erythematosus. Pediatr Pathol 7:245–259
Prendiville JS, Cabral DA, Poskitt KJ, Au S, Sargent MA (2003) Central nervous system involvement in neonatal lupus erythematosus. Pediatr Dermatol 20:60–67
Saleeb S, Copel J, Friedman D, Buyon JP (1999) Comparison of treatment with fluorinated glucocorticoids to the natural history of autoantibody-associated congenital heart block. Arthritis Rheum 42(11):2335–2345
Sawant S, Amladi ST, Wadhawa SL, Nayak CS, Nikam BP (2007) Cutaneous neonatal lupus erythematosus with unusual features. Indian J Dermatol Venereol Leprol 73:250–252
See A, Wargon O, Lim A, Sugo E, Le K (2005) Neonatal lupus erythematosus presenting as papules on the feet. Aust J Dermatol 46:172–176
Spence D, Hornberger L, Hamilton R, Silverman ED (2006) Increased risk of complete congenital heart block in infants born to women with hypothyroidism and anti-Ro and/or anti-La antibodies. J Rheumatol 33:167–170
Taylor-Albert E, Reichlin M, Toews WH, Overholt ED, Lee LA (1997) Delayed dilated cardiomyopathy as a manifestation of neonatal lupus: case reports, autoantibody analysis, and management. Pediatrics 99:733–735
Wisuthsarewong W, Soongswang J, Chantorn R (2011) Neonatal lupus erythematosus: clinical character, investigation, and outcome. Pediatr Dermatol 28(2):115–121
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Laurinaviciene, R., Christesen, H.T. & Bygum, A. New aspects in the clinical spectrum of neonatal lupus. Eur J Pediatr 171, 801–805 (2012). https://doi.org/10.1007/s00431-011-1618-z
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DOI: https://doi.org/10.1007/s00431-011-1618-z