26 February 2026
: Case report 
Systemic Manifestations of Neonatal Lupus in an Infant Born to an Asymptomatic Mother: A Case Report of Anemia and Transaminitis
Rare disease
Diah Lintang Kawuryan ABCDEFG 1, Zahrah Hikmah
ACDEF 2,3*, Azwin Mengindra Putera CDEF 2,3, Anang Endaryanto DEF 2,3
DOI: 10.12659/AJCR.951138
Am J Case Rep 2026; 27:e951138
Table 2 Case timeline.
| Time | Findings and management |
|---|---|
| At birth | Full-term infant with intrauterine growth restriction; no respiratory distress, cyanosis, seizures, or jaundice; received standard neonatal care including vitamin K |
| 1 week after birth | Multiple annular erythematous skin lesions on the face, chest, abdomen, and extremities; no improvement with topical hydrocortisone 1% |
| 1 month after birth (hospital admission) | Laboratory: normocytic normochromic anemia (Hb 8.6 g/dL), thrombocytopenia (69 000/μL), elevated AST/ALT (268/238 U/L), ANA positive (400 AU/mL), and negative Coombs test. Echocardiography: secundum atrial septal defect and tricuspid regurgitation. Skin histopathology: vacuolar degeneration of basal keratinocytes, lymphocytic infiltration at the dermo-epidermal junction, and melanophages. Treatment: oral prednisone 0.5 mg/kg/day; parental education to avoid ultraviolet exposure |
| 1 month after discharge | Clinical and laboratory improvement; skin lesions markedly improved; liver enzymes normalized |
| 4 months after discharge | Complete clinical resolution; skin lesions resolved; Hb 11.8 g/dL; platelet count 476 000/μL; prednisone discontinued |
| Hb – hemoglobin; AST – aspartate aminotransferase; ALT – alanine aminotransferase; ANA – antinuclear antibody. | |