Autoantibody responses to cardiolipin and DNA in infancy: association withlymphocytic panniculitis

We report an infant with anticardiolipin (aCL) antibodies who presented wit h erythematous nodular skin lesions and elevated liver enzyme levels. The c utaneous 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) antib odies. There were no detectable antibodies to small nuclear ribonucleoprote ins including Ro/SSA and La/SSB. His mother was consistently seronegative f or any of these antibodies. Without corticosteroid therapy, cutaneous lesio ns resolved and anticardiolipin antibodies, but not anti-dsDNA and ssDNA an tibodies, normalized within 16 months after the onset of the disease. Our p atient demonstrated an uncommon presentation of aCL related cutaneous manif estation, the presentation with panniculitis being only the third such pati ent reported in the literature. Of great interest was the appearance of aCL antibodies and skin lesions during very early infancy.