The antibodies should be measured under the following conditions: 1) suspicion of SLE and primary SS (even if the ANA is negative), 2) mothers of babies with neonatal lupus
and congenital heart block, and 3) patients with SLE who are planning to get pregnant.
Neonatal lupus developed in 10 cases, four of which were rash only.
Cardiac manifestations of neonatal lupus erythematosus: guidelines to management, integrating clues from the bench and bedside.
Autoimmune-associated congenital heart block: demographics, mortality, morbidity and recurrence rates obtained from a national neonatal lupus registry.
To determine whether maternal cells might play a role in neonatal lupus syndrome, Stevens and colleagues identified four male infants that had died prior to or shortly after birth from heart damage and whose mothers produced anti-Ro and anti-La antibodies.
The maternal cells were present at much higher levels in the neonatal lupus hearts than in controls.
To further analyze the onset of neonatal lupus syndrome, Stevens is now conducting a study of twins and triplets in which only one of the siblings develops the disease as well as examining whether other organ systems besides the heart may be affected.
Neonatal lupus, he explained, is a serious condition occurring in children whose mothers have anti-Rho/SSA antibodies, which can cross the placenta.
And it has been reported that children with neonatal lupus are at increased risk of developing autoimmune disorders in their first years," he explained.
9) Also, similar to other neonatal lupus
syndromes, anti-SS-A antibody in pregnant women places the fetus at high risk for development of complete heart block, one of the possibly fatal complications in neonatal lupus
syndrome with an estimated mortality rate of more than 30%.
These statistics have emerged from the ongoing Research Registry for Neonatal Lupus, which now includes more than 300 women.
Among the infants with manifestations of neonatal lupus, 15 had congenital heart block only, three had heart blocks plus a rash, and seven had the rash alone.