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Case report
Neonatal lupus erythematosus presenting with rash, thrombocytopenia compounded by cytomegalovirus colonisation: a diagnostic dilemma
  1. Gopal Agrawal,
  2. Bincy Varghese,
  3. Manish Balde and
  4. Sanjay Wazir
  1. Department of Pediatrics and Neonatology, Cloudnine Hospital, Gurgaon, Haryana, India
  1. Correspondence to Dr Gopal Agrawal; drgopalagrawal2000{at}


Neonatal lupus erythematosus (NLE) should be considered when a newborn develops atrioventricular heart block along with the presence of autoantibodies to Sjogren’s syndrome autoantigens in the maternal serum. NLE can also present with features such as cutaneous lesions, hepatic dysfunction or haematological abnormalities. Differential diagnosis usually includes congenital infections as there is a significant overlap of symptoms with NLE. We report a case of NLE who had multiorgan involvement with macular erythematous skin lesions present at birth, and on investigation was found to have cytomegalovirus (CMV) infection. The diagnostic dilemma was whether to consider this infection as symptomatic or just colonisation. In the infant described, the absence of end organ damage specific to CMV infection (hearing loss, intracranial calcifications, retinitis, brain involvement) made a diagnosis of symptomatic CMV unlikely.

  • dermatology
  • materno-fetal medicine

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  • Contributors GA: conceived and wrote the manuscript. SW: critically reviewed and finalised the manuscript. All authors involved in clinical care of the infant, read and approved the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Parental/guardian consent obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.