Neonatal lupus syndrome in a Nigerian child

Abstract

Neonatal lupus is a rare syndrome resulting from passively transferred maternal autoantibodies during pregnancy. A male infant was delivered at term to a 29-year-old primiparous woman who was diagnosed of systemic lupus erythematosus 2 years earlier and had detectable levels of autoantibodies (antinuclear antibody (ANA), anti-dsDNA, anti-Ro and anti-La/SSB) in second trimester. However, the pregnancy was otherwise uneventful. He presented at the age of 8 week with a widespread hypopigmented macular rash on the trunk and patchy alopecia involving the hair line and the occipito-parietal regions of 3 weeks duration, anaemia and symptomatic thrombocytopaenia. Serologic test for autoantibodies was positive for ANA and anti-La/SSB. Further evaluation was normal. He was managed conservatively with blood products and topical corticosteroids. Mother was also advised to avoid direct exposure to sunlight and fluorescent light. Haematological parameters gradually normalised over 2 months and the skin lesions resolved completely by the age of 6 months.

Figure 1

Cutaneuos bleeds in neonatal lupus syndrome with thrombocytopaenia and anaemia.

Figure 2

Cutaneous lupus manifesting as dyspigmented lesions in an 8-week-old African infant. Lesions gradually disappeared by the age of 6 months without sequelae, coinciding with the absence of anti-La/SSB antibodies in the infant.

Figure 3

(A) Patchy hair loss along the hair-line in neonatal lupus syndrome. (B) Patchy alopecia in the parieto-occipital region in neonatal lupus syndrome.