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Neonatal Lupus — SCE Dermatology MCQ

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HardPaediatric DermatologyNeonatal LupusSCE Dermatology

An anti-Ro/SSA-positive woman previously had a baby with congenital complete heart block due to neonatal lupus. She asks about a further pregnancy. Which counselling statement is most accurate?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: E — Recurrence 16–18%; serial fetal cardiac surveillance; established complete heart block usually permanent

The best answer is “Recurrence 16–18%; serial fetal cardiac surveillance; established complete heart block usually permanent”. Maternally transferred anti-Ro/SSA antibodies can recur after an affected child, so specialist fetal surveillance is needed. Non-cardiac neonatal lupus features settle as maternal antibody clears, whereas established complete heart block is permanent. The low recurrence figure and spontaneous resolution in the second option are incorrect; the isolated-antibody restriction in the final option is unsupported.

Reference: NHSGGC anti-Ro and anti-La neonatal guideline: https://www.clinicalguidelines.scot.nhs.uk/ggc-paediatric-guidelines/ggc-paediatric-guidelines/neonatology/anti-ro-anti-la-antibodies-guideline-for-the-management-of-babies-born-to-mothers-with-systemic-lupus-erythematosus-sle-and-other-autoimmune-disorders-698/