Neonatal Lupus Erythematosus – Review of Pathophysiology and Clinical Implications

Neonatal lupus erythematosus is a rare disease that can affect different organs, mainly the skin and heart. In either asymptomatic pregnant women or with autoimmune pathology who carry antibodies directed to Ro/SSA, La/SSB and RNP, the transplacentar passage of these autoantibodies after the 16th week of gestation may cause transient lesions in target organs. The majority regress as the maternal antibodies are cleared from the circulation, except for heart lesions where fibrosis can induce definitive lesions. Although the importance of these antibodies in the pathophysiology of neonatal lupus is well recognized, their presence is not sufficient for the development of the disease and other factors, such as genetic and environmental factors, must be recognized. Most manifestations are benign and limited. Atrioventricular block is an exception because it carries a significant mortality and morbidity, emphasizing the value of an early diagnosis. The disease can carry a higher risk of autoimmune disease in the child and its mother when asymptomatic. Currently, the main focus of the investigation of neonatal lupus erythematosus lies on the search for reliable markers that predict the specific involvement of fetal organs and for a safe and effective treatment to prevent definitive lesions.