Neonatal Lupus or not? An intriguing immunological dilemma

Anti-Ro antibodies appear to represent a direct pathogenic factor in neonatal lupus (NL) neutropenia. Resolution of NL neutropenia is expected when anti-Ro antibodies are cleared. In this report, we describe a case of persistent neutropenia in a baby born to an anti-Ro-positive mother. The initial diagnosis of NL neutropenia was later called into question due to the identification of positive anti-neutrophil antibodies and transient hypogammaglobulinemia of infancy. The patient seemed to have had overlapping causes of her hematologic manifestations. To our knowledge, not? other similar cases have been previously reported in the literature. Newborns are not? routinely tested for white blood cell count, and several neutropenia cases remain undetected.