A Case of Neonatal Lupus Presenting with Fever and Rash in Early Infancy with Anti–dsDNA Antibodies, Born to an Asymptomatic Mother Negative for Anti–dsDNA Antibodies

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ID: 318953
2026
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Abstract
Abstract Neonatal lupus erythematosus (NLE) is an autoimmune disorder in which maternal antibodies, particularly anti-SS-A or anti–SS-B antibodies, cause complications in fetal or neonatal cases. We report a case of NLE in an infant born to an asymptomatic mother, presenting with fever and elevated C-reactive protein (CRP) despite the absence maternal anti–dsDNA antibodies. The patient was a 35-day-old male infant who presented with rash and fever. Laboratory findings included elevated CRP and ferritin, soluble interleukin-2 receptor, hypocomplementemia, and elevated D-dimer levels. NLE or urticarial vasculitis secondary to possible infantile-onset systemic lupus erythematosus (SLE) was considered in the differential diagnosis. The infant and mother tested positive for anti–SS-A and anti–SS-B antibodies, with titers decreasing over time, leading to a final diagnosis of NLE. Although anti–dsDNA antibodies are typically maternal in origin, the mother in this case was repeatedly negative, making transplacental transfer unlikely and suggesting possible de novo antibody production by the infant. Although fever is rare in NLE, this case presented with systemic symptoms similar to SLE, including fever, elevated CRP, and hypocomplementemia. In some cases of NLE, systemic symptoms similar to SLE may be observed in addition to the rash, and anti-dsDNA antibodies may also be positive serologically.
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Authors Mei Takemoto, Koji Nagatani, Sawa Tomomatsu, Hiromitsu Miura, Naoki Yakushiji
Journal Modern Rheumatology Case Reports
Year 2026
DOI
10.1093/mrcr/rxag055
URL
https://doi.org/10.1093/mrcr/rxag055
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