Neonatal Lupus Erythematosus

Joanna M. Burch, Lela A. Lee and William L. Weston

Disclosures

Dermatology Nursing. 2002;14(3) 

In This Article

Pathogenesis

Ninety-eight percent of reported babies have anti-Ro antibodies. About one-third will also have anti-La antibodies. These are IgG antibodies and pass the placenta to the fetus (Brucato, Buyon, Horsfall, Lee, & Reichlin, 1999).

Ro and La are saline soluble nuclear antigens ubiquitous in all nucleated cells. They are composed of RNA-protein complexes (Silverman & Laxer, 1997). The pathogenesis of the disease involves anti-Ro and anti-La antibodies, but their simple presence does not necessitate clinical disease. Mothers of neonates with NLE almost always have anti-Ro and/or anti-La antibodies that can often be detected in their infants' sera. However, siblings will not all have NLE, nor will they have the same manifestations of NLE. Mothers of babies with NLE rarely have skin lesions like those seen in their infants, nor do they get heart block. A guinea pig model in which sera from NLE mothers was injected, showed deposition of antibodies in tissues, but did not produce clinical NLE. The mere presence of the antibodies is not sufficient to produce disease, indicating a complex mechanism of injury (Lee, 1993).

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