Congenital cytomegalovirus infection after maternal persistent immunoglobulin-M antibodies against cytomegalovirus prior to conception

2013 ◽  
Vol 2 (1-2) ◽  
Author(s):  
Yoshiyuki Nakajima ◽  
Naoki Masaoka ◽  
Tatsuo Yamamoto
Keyword(s):  
Cytomegalovirus Infection ◽  
Congenital Infection ◽  
Maternal Serum ◽  
Immunoglobulin M ◽  
Cmv Infection ◽  
Congenital Cytomegalovirus Infection ◽  
Congenital Cytomegalovirus ◽  
Congenital Cmv Infection ◽  
Infant Girl ◽  
Congenital Cmv

AbstractWe describe a case of congenital cytomegalovirus (CMV) infection transmitted by an immunocompetent woman infected before conception with continuous hyper CMV-immunoglobulin M (IgM). A 33-year-old woman whose CMV-IgM levels were stable more than 8 months before conception was referred at 35 gestational weeks due to fetal unilateral cerebral ventriculomegaly. The maternal serum CMV-IgG was 61.7 U/mL, and the CMV-IgM was 3.89 U/mL. An infant girl weighing 2297 g was delivered transvaginally. The neonate was found to have congenital CMV infection. After delivery, the high maternal CMV-IgM level has continued for more than 2 years. In conclusion, although continuous hyper CMV-IgM is rare, the infants of infected women may develop congenital infection. It is our hope that the information provided in the present case will further aid clinicians in counseling patients who find themselves in this situation.

scholarly journals Low total IgM values and high cytomegalovirus loads in the blood of newborns with symptomatic congenital cytomegalovirus infection

2015 ◽  
Vol 43 (2) ◽  
Author(s):  
Yoko Kobayashi ◽  
Ichiro Morioka ◽  
Tsubasa Koda ◽  
Yuji Nakamachi ◽  
Yoko Okazaki ◽  
...  
Keyword(s):  
Immunoglobulin M ◽  
Cmv Infection ◽  
Congenital Cytomegalovirus Infection ◽  
Asymptomatic Group ◽  
Congenital Cytomegalovirus ◽  
Neurological Outcomes ◽  
Symptomatic Group ◽  
Laboratory Markers ◽  
Congenital Cmv Infection ◽  
Congenital Cmv

AbstractNeurological outcomes differ considerably between symptomatic and asymptomatic infants with congenital cytomegalovirus (CMV) infection. Our objective was to characterize laboratory markers in symptomatic newborns in comparison with asymptomatic newborns with congenital CMV infection.Ten newborns with symptomatic and 13 newborns with asymptomatic congenital CMV infection were included in this 3-year prospective cohort study. Total immunoglobulin M (IgM), CMV-IgM, CMV antigenemia, and CMV-DNA in blood and urine were measured and their positive rates and quantitative values compared between the symptomatic and asymptomatic groups.Fifty percent of newborns in the symptomatic group were positive based on total IgM; this was significantly lower than in the asymptomatic group (100%). Quantitative total IgM values were significantly lower, and there were significantly more copies of CMV-DNA in the blood of symptomatic newborns than in asymptomatic newborns (median values for total IgM: 14 vs. 43 mg/dL and blood CMV-DNA: 3.2×10Low total IgM values and high blood CMV loads were associated with the presence of symptoms in newborns with congenital CMV infection.

Congenital Cytomegalovirus Infection: Diagnostic and Prognostic Significance of the Detection of Specific Immunoglobulin M Antibodies in Cord Serum

PEDIATRICS ◽  
1982 ◽  
Vol 69 (5) ◽  
pp. 544-549
Author(s):  
Paul D. Griffiths ◽  
Sergio Stagno ◽  
Robert F. Pass ◽  
Richard J. Smith ◽  
Charles A. Alford
Keyword(s):  
Cytomegalovirus Infection ◽  
Prognostic Significance ◽  
Immunoglobulin M ◽  
Maternal Infection ◽  
Cmv Infection ◽  
Congenital Cytomegalovirus Infection ◽  
Congenital Cytomegalovirus ◽  
Congenital Infections ◽  
Congenital Cmv Infection ◽  
Specific Immunoglobulin

Specific immunoglobulin M antibodies were detected by radioimmunoassay (RIA-IgM) in cord sera from 83/93 (89%) babies congenitally infected with cytomegalovirus (CMV) but in 0/104 cord sera from uninfected control subjects. The type of maternal infection did not affect the ability of the assay to identify congenital infections, but increased RIA-IgM titers were found more frequently in cord sera from babies infected following primary CMV infections (9/18; 50%) than following recurrent CMV infections (1/12; 8%) (P < .05). The magnitude of the fetal immune response was related to disease inasmuch as 14/40 (35%) babies with increased RIA-IgM titers were symptomatic at birth compared with 1/43 (2%) with lower titers (P < .001). When combined with the results of testing for rheumatoid factor and total IgM, the RIA-IgM assay defined subgroups of babies with generally poor (7/15; 47% symptomatic at any stage) or generally good (0/21 symptomatic) prognoses. Prospective studies currently identifying cases of congenital CMV infection may wish to use these three serologic techniques as the results obtained appear to have prognostic significance for those babies who are initially asymptomatic.

Rare etiology of arthrogryposis multiplex congenita at term: congenital cytomegalovirus infection

2018 ◽  
Vol 8 (1) ◽  
Author(s):  
Shani Delaney ◽  
Cigdem Ussakli ◽  
Corinne Fligner
Keyword(s):  
Cytomegalovirus Infection ◽  
Arthrogryposis Multiplex Congenita ◽  
Body Parts ◽  
Placental Pathology ◽  
Cmv Infection ◽  
Congenital Cytomegalovirus Infection ◽  
Case Presentation ◽  
Congenital Cytomegalovirus ◽  
Congenital Cmv Infection ◽  
Congenital Cmv

Abstract Background Arthrogryposis multiplex congenita is the presence of multiple congenital contractures of two or more body parts. Congenital cytomegalovirus (CMV) infection is a rare etiology of arthrogryposis. Case presentation We report a case of intrauterine fetal akinesia and arthrogryposis multiplex congenita delivered at term with subsequent neonatal demise. Placental pathology and autopsy revealed congenital CMV infection. Conclusions Evaluation for potential CMV infection is an important part of the arthrogryposis evaluation which is often missed due to lack of maternal infectious symptoms during pregnancy.

scholarly journals Update on congenital cytomegalovirus infection: Prenatal prevention, newborn diagnosis, and management

2020 ◽  
Vol 25 (6) ◽  
pp. 395-395 ◽  
Author(s):  
Michelle Barton ◽  
A Michael Forrester ◽  
Jane McDonald
Keyword(s):  
Cytomegalovirus Infection ◽  
Multidisciplinary Approach ◽  
Congenital Infection ◽  
Cmv Infection ◽  
Congenital Cytomegalovirus Infection ◽  
Congenital Cytomegalovirus ◽  
Common Cause ◽  
Hygienic Measures ◽  
Reduce Risk ◽  
Congenital Cmv

Abstract Cytomegalovirus (CMV) is the leading cause of congenital infection and the most common cause of non-genetic sensorineural hearing loss (SNHL) in childhood. Although most infected infants are asymptomatic at birth, the risk for SNHL and other neurodevelopmental morbidity makes congenital CMV (cCMV) a disease of significance. Adherence to hygienic measures in pregnancy can reduce risk for maternal CMV infection. The prompt identification of infected infants allows early initiation of surveillance and management. A multidisciplinary approach to management is critical to optimize outcomes in affected infants.

Early high CMV seroprevalence in pregnant women from a population with a high rate of congenital infection

2012 ◽  
Vol 141 (10) ◽  
pp. 2187-2191 ◽  
Author(s):  
A. Y. YAMAMOTO ◽  
R. A. C. CASTELLUCCI ◽  
D. C. ARAGON ◽  
M. M. MUSSI-PINHATA
Keyword(s):  
Pregnant Women ◽  
Primary Infection ◽  
Congenital Infection ◽  
High Rate ◽  
Cmv Infection ◽  
Congenital Cytomegalovirus ◽  
Younger Age ◽  
Congenital Cmv Infection ◽  
Stratified Sample ◽  
Congenital Cmv

SUMMARYCongenital cytomegalovirus (CMV) infection rates increase with maternal seroprevalence due to transmission from maternal non-primary infection. CMV seroprevalence estimates of pregnant women are needed for planning strategies against congenital CMV transmission. We aimed to determine the age-specific prevalence of serum antibodies for CMV in a representative age-stratified sample of unselected pregnant women from a Brazilian population. A total of 985 pregnant women, aged 12–46 years (median 24 years), were enrolled. Overall CMV seroprevalence was 97% (95% confidence interval 95·8–98·0), with age-specific (years) prevalence as follows: 12–19 (96·3%), 20–24 (97·7%), 25–29 (97·1%), and 30–46 (96·7%). CMV seroprevalence is almost universal (97%) and is found at similar levels in pregnant women of ages ranging from 12 to 46 years. Because high CMV seroprevalence is found even in women of a younger age in this population, this finding suggests that the majority of primary CMV infections occur early, in infancy or childhood. As a consequence, vaccines currently under development to prevent primary infection may not be a solution for the prevention of congenital CMV infection in this population.

Clinical and epidemiological features of congenital cytomegalovirus infection globally

2015 ◽  
Vol 36 (4) ◽  
pp. 153 ◽  
Author(s):  
Wendy J van Zuylen
Keyword(s):  
Vision Loss ◽  
Clinical Importance ◽  
Mental Disability ◽  
Cmv Infection ◽  
Congenital Cytomegalovirus Infection ◽  
Congenital Cytomegalovirus ◽  
Global Epidemiology ◽  
Congenital Cmv Infection ◽  
General Community ◽  
Congenital Cmv

Human cytomegalovirus (CMV) is the most common non-genetic cause of congenital disability. As a herpesvirus that infects the majority of the population, CMV is able to establish a lifelong latent infection in the host. Any time during pregnancy, a primary CMV infection, reactivation of latent CMV or a new viral strain can infect the placenta and the developing foetus, resulting in congenital CMV infection. Each year, an estimated 2000 children are born with congenital CMV infection in Australia, leaving ~500 children with permanent disabilities such as hearing or vision loss, or mental disability. Despite the clinical importance of congenital CMV, there is limited awareness and knowledge in the medical and general community about congenital CMV infection. This article reviews the global epidemiology and clinical features of maternal and congenital CMV infections.

scholarly journals Birth Prevalence of Congenital Cytomegalovirus (CMV) infection in a cohort of pregnant women in Bangladesh

2018 ◽  
Vol 43 (2) ◽  
pp. 77-81
Author(s):  
Munira Jahan ◽  
Nahida Sultana ◽  
Ridwana Asma ◽  
Shahina Tabassum ◽  
Md. Nazrul Islam
Keyword(s):  
Pregnant Women ◽  
Viral Infections ◽  
Congenital Infection ◽  
High Seroprevalence ◽  
Cmv Infection ◽  
Congenital Cytomegalovirus ◽  
Birth Prevalence ◽  
Congenital Cmv Infection ◽  
Cmv Reactivation ◽  
Congenital Cmv

Cytomegalovirus (CMV) is a frequent cause of congenital infection in humans in all regions of the world. In contrast to most congenital viral infections, congenital CMV infection and disease have been consistently demonstrated in populations with a high seroprevalence. Three hundred pregnant women were studied prospectively in their 1st, 2nd and 3rd trimester to determine the seroprevalence and seroconversion of CMV in pregnancy. After birth, babies were also tested for anti CMV IgM to determine the rate of birth prevalence. Anti CMV IgG and IgM tests were performed by chemiluminescence methods. All 300 (100%) pregnant women were anti CMV IgG positive and 180 (60%) were subsequently anti CMV IgM positive during different trimesters of pregnancy. Birth prevalence of CMV IgM antibody was 1.3% among babies of anti CMV IgM positive mothers whereas none in CMV IgM negative mothers (OR 1.01, 95% CI .996-1.027).It may be concluded that CMV IgG seroprevalence is high among Bangladeshi pregnant women and the rate of CMV reactivation is also high during pregnancy. Despite protection by maternal immunity a certain percent of babies acquire congenital CMV infection.

scholarly journals Congenital cytomegalovirus: the invisible problem

2015 ◽  
Vol 36 (4) ◽  
pp. 152
Author(s):  
Bill Rawlinson
Keyword(s):  
Cytomegalovirus Infection ◽  
Congenital Infection ◽  
Mental Disability ◽  
Congenital Cytomegalovirus Infection ◽  
Great Pleasure ◽  
Congenital Cytomegalovirus ◽  
Congenital Infections ◽  
The Subject ◽  
Serious Disease ◽  
Congenital Cmv

It is a great pleasure mixed with some sadness to write this editorial. The entire November issue is around the subject of congenital infection, with the focus on the most common, serious cause of congenital malformation in Australia – congenital cytomegalovirus. Infection with cytomegalovirus (CMV) causes serious disease in children globally, resulting in congenital infections present in ~2000 Australian newborns every year, of whom most are asymptomatic, with ~450 per annum (pa) affected by hearing loss, mental disability and other illnesses. Some of the key clinical features of congenital infection are outlined here in articles by Wendy van Zuylen, Klaus Hamprecht and Robert George, and the pathogenetic features in Lenore Pereira’s paper. Treatment and vaccination are moving ahead (as discussed in papers from some key Italian groups), although not fast enough for many of us – as parents of children with CMV discuss in two papers here. We also include papers on other causes of congenital infection that are much less common than congenital CMV in Australia. Although these are not related to congenital CMV clinically, with very different medical and epidemiological settings, it is important to put congenital CMV in context, as well as to draw attention to other important causes of congenital infection.

Child Care Workers and Children with Congenital Cytomegalovirus Infection

PEDIATRICS ◽  
1985 ◽  
Vol 75 (5) ◽  
pp. 971-973
Author(s):  
ROBERT F. PASS ◽  
JANET S. KINNEY
Keyword(s):  
Young Women ◽  
Child Care Workers ◽  
Cmv Infection ◽  
Congenital Cytomegalovirus Infection ◽  
Congenital Cytomegalovirus ◽  
Care Givers ◽  
Child Bearing ◽  
Care Workers ◽  
Congenital Cmv Infection ◽  
Congenital Cmv

Children with congenital cytomegalovirus (CMV) infection shed virus intermittently in saliva and urine for months to years; viruria often persists for five or more years.1 This feature of congenital CMV infection is a problem for institutions such as hospitals and infant developmental centers, as well as for persons who provide care for children with congenital CMV infection. There is concern that these children will transmit CMV to their care givers, who are usually young women in their child-bearing years. Unfortunately, this concern can lead to exclusion of handicapped children with congenital CMV infection from special education programs designed to teach children with motor, hearing or other CNS damage.

scholarly journals Preexisting antibodies can protect against congenital cytomegalovirus infection in monkeys

2017 ◽  
Author(s):  
Cody S. Nelson ◽  
Diana Vera Cruz ◽  
Dollnovan Tran ◽  
Kristy M. Bialas ◽  
Lisa Stamper ◽  
...  
Keyword(s):  
Fetal Loss ◽  
Congenital Infection ◽  
Neonatal Infection ◽  
Congenital Cytomegalovirus Infection ◽  
Nonhuman Primate Model ◽  
Primate Model ◽  
Congenital Cytomegalovirus ◽  
Congenital Cmv Infection ◽  
Hyperimmune Globulin ◽  
Congenital Cmv

AbstractHuman cytomegalovirus (HCMV) is the most common congenital infection and a known cause of microcephaly, sensorineural hearing loss, and cognitive impairment among newborns worldwide. Natural maternal HCMV immunity reduces the incidence of congenital infection, but does not prevent the disease altogether. We employed a nonhuman primate model of congenital CMV infection to investigate the ability of preexisting antibodies to protect against placental CMV transmission. Pregnant, CD4+ T cell-depleted, rhesus CMV (RhCMV)-seronegative rhesus monkeys were treated with either standardly-produced hyperimmune globulin (HIG) from RhCMV-seropositive macaques or dose-optimized, potently RhCMV-neutralizing HIG prior to intravenous challenge with an RhCMV swarm. HIG passive infusion provided complete protection against fetal loss in both groups, and the potently-neutralizing HIG additionally inhibited placental transmission of RhCMV. Our findings suggest that antibody alone at the time of primary infection can prevent congenital CMV and therefore could be a primary target of vaccines to eliminate this neonatal infection.

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