Autoantibody responses to cardiolipin and DNA in infancy: association with lymphocytic panniculitis

Abstract

We report an infant with anticardiolipin (aCL) antibodies who presented with erythematous nodular skin lesions and elevated liver enzyme levels. The cutaneous manifestation was histologically lymphocytic lobular panniculitis with vasculitic and hemorrhagic changes. The infant also had low levels of anti-double stranded DNA (dsDNA) and anti-single stranded DNA (ssDNA) antibodies. There were no detectable antibodies to small nuclear ribonucleoproteins including Ro/SSA and La/SSB. His mother was consistently seronegative for any of these antibodies. Without corticosteroid therapy, cutaneous lesions resolved and anticardiolipin antibodies, but not anti-dsDNA and ssDNA antibodies, normalized within 16 months after the onset of the disease. Our patient demonstrated an uncommon presentation of aCL related cutaneous manifestation, the presentation with panniculitis being only the third such patient reported in the literature. Of great interest was the appearance of aCL antibodies and skin lesions during very early infancy.

Emergence of panniculitis and haemophagocytic syndrome in a patient with chronic systemic lupus erythematosus

“…Anti-cardiolipin-IgM antibody, also identified in our case, is one of the candidate causal antibodies of this association, as anti-cardiolipin antibodies have been reported to potentially induce the autoimmuneassociated haemophagocytic syndrome, 8 or lympho-cytic panniculitis. 9 Further clinical experiences are required to confirm this idea.…”