Discordant Congenital Cytomegalovirus Infection in Twins
1
조회
0
다운로드
1
인용
0
참고문헌
키워드
초록
Cytomegalovirus (CMV) infection is one of the most common congenital infections. The first case of discordant congenital CMV infection in twins occurred in Korea. A 31-year-old woman became pregnant with twins (dichorionic-diamniotic). An elective caesarean section was performed at 37 weeks. The first baby was male, weighing 2,410 g with an Apgar score of 8/9. The second baby was female, weighing 1,380 g with an Apgar score of 5/8. She had experienced intrauterine growth retardation, and presented with microcephaly, micrognathia, and joint stiffness. During the work-up for discordant twins, the second baby's serum test was positive for CMV immunoglobulin M. Her urine, blood, and cerebrospinal fluid (CSF) were CMV polymerase chain reaction positive. The first baby's CMV tests were negative. Ophthalmologic exam and audiometry performed on the second baby showed CMV retinitis and bilateral sensorineural hearing loss. She was treated with intravenous ganciclovir. Currently, she is bed-ridden and has significant developmental delay. Although the causes of discordant congenital CMV infection in twins are unclear, this case shows that discordant congenital CMV infection should be considered in twins with significant differences in intrauterine growth or clinical symptoms after birth.
Abstract
Cytomegalovirus (CMV) infection is one of the most common congenital infections. The first case of discordant congenital CMV infection in twins occurred in Korea. A 31-year-old woman became pregnant with twins (dichorionic-diamniotic). An elective caesarean section was performed at 37 weeks. The first baby was male, weighing 2,410 g with an Apgar score of 8/9. The second baby was female, weighing 1,380 g with an Apgar score of 5/8. She had experienced intrauterine growth retardation, and presented with microcephaly, micrognathia, and joint stiffness. During the work-up for discordant twins, the second baby's serum test was positive for CMV immunoglobulin M. Her urine, blood, and cerebrospinal fluid (CSF) were CMV polymerase chain reaction positive. The first baby's CMV tests were negative. Ophthalmologic exam and audiometry performed on the second baby showed CMV retinitis and bilateral sensorineural hearing loss. She was treated with intravenous ganciclovir. Currently, she is bed-ridden and has significant developmental delay. Although the causes of discordant congenital CMV infection in twins are unclear, this case shows that discordant congenital CMV infection should be considered in twins with significant differences in intrauterine growth or clinical symptoms after birth.
참고문헌 (15)
- Wu HY, "Cytomegalovirus infection and fetal death in one monozygotic twin", Taiwan J Obstet Gynecol, 50, pp.230~232 (2011)
- Bodeus M, "Increased risk of cytomegalovirus transmission in utero during late gestation", Obstet Gynecol, 93(5 Pt 1), pp.658~660 (1999)
- Lazzarotto T, "Congenital cytomegalovirus infection in twin pregnancies: viral load in the amniotic fluid and pregnancy outcome", Pediatrics, 112, pp.e153~e157 (2003)
- Simioni C, "Twin pregnancy and congenital cytomegalovirus : case report and review", J Matern Fetal Neonatal Med, 26, pp.622~624 (2013)
- Ahlfors K, "On the unpredictable development of congenital cytomegalovirus infection. A study in twins", Early Hum Dev, 18, pp.125~135 (1988)
- Egana-Ugrinovic G, "Congenital cytomegalovirus infection among twin pairs", J Matern Fetal Neonatal Med, 29, pp.3439~3444 (2016)
- Kawana K, "Differential clinical manifestations of congenital cytomegalovirus infection between dizygotic twins : a case report", Am J Perinatol, 21, pp.383~386 (2004)
- Samedi VM, "Comparison of presentation, course, and outcome of congenital and acquired cytomegalovirus infection in twins", AJP Rep, 6, pp.e1~e5 (2016)
- Yinon Y, "Prenatal diagnosis and outcome of congenital cytomegalovirus infection in twin pregnancies", BJOG, 113, pp.295~300 (2006)
- Griesmaier E, "Neurodevelopmental outcome following congenital cytomegalovirus infection in preterm infants with twin-to-twin transfusion syndrome : a case report", Klin Padiatr, 222, pp.312~314 (2010)
- Seguin J, "Congenital cytomegalovirus infection in one monozygotic twin", JAMA, 260, pp.3277~ (1988)
- Nakajima J, "Congenital cytomegalovirus infection in monozygotic twins with twin-to-twin transfusion syndrome", Indian Pediatr, 52, pp.429~431 (2015)
- Nigro G, "Hyperimmunoglobulin therapy for a twin fetus with cytomegalovirus infection and growth restriction", Am J Obstet Gynecol, 180, pp.1222~1226 (1999)
- Azam AZ, "Prenatal diagnosis of congenital cytomegalovirus infection", Obstet Gynecol, 97, pp.443~448 (2001)
- Manoura A, "Symptomatic congenital cytomegalovirus infection in one twin after recurrent maternal infection", Pediatr Int, 48, pp.88~90 (2006)