Neonatal lupus is caused by autoantibodies crossing the placenta from the mother to the fetus. Mothers of the affected infants maybe asymptomatic at the time of delivery. Most common presentation is skin lesions on the face, eyes(raccoon eyes) and scalp. Cardiac involvement develops between 16th to 24th week of pregnancy and can manifest as 1st/2nd/3rd degree heart block. Other features include hepatobiliary disease and hematological abnormalities. Most of the manifestations are transient and resolve over time.
Children with signs of neonatal lupus should be tested for anti-Ro, anti-La and anti-U1RNP antibodies.