1. Prenatal Management of Congenital Human Cytomegalovirus Infection in Seropositive Pregnant Patients Treated with Azathioprine
- Author
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Milena Furione, Patrizia Rovere Querini, Paolo Cavoretto, Chiara Fornara, Cristina Baldoli, Massimo Candiani, G. Gaeta, Daniele Lilleri, Arsenio Spinillo, Graziano Barera, Alessia Arossa, Antonella Poloniato, Cavoretto, P. I., Fornara, C., Baldoli, C., Arossa, A., Furione, M., Candiani, M., Rovere-Querini, P., Barera, G., Poloniato, A., Gaeta, G., Spinillo, A., and Lilleri, D.
- Subjects
0301 basic medicine ,Ganciclovir ,Human cytomegalovirus ,Fetal MRI ,viruses ,Clinical Biochemistry ,Azathioprine ,Case Report ,Asymptomatic ,Serology ,congenital cytomegalovirus infection ,03 medical and health sciences ,0302 clinical medicine ,fetal MRI ,Pregnancy ,Ultrasound ,medicine ,Congenital cytomegalovirus infection ,lcsh:R5-920 ,030219 obstetrics & reproductive medicine ,azathioprine ,business.industry ,ultrasound ,virus diseases ,Valganciclovir ,biochemical phenomena, metabolism, and nutrition ,medicine.disease ,Ulcerative colitis ,030104 developmental biology ,Immunology ,pregnancy ,medicine.symptom ,business ,lcsh:Medicine (General) ,medicine.drug - Abstract
Human cytomegalovirus (HCMV) is the leading infectious agent causing congenital disabilities. The risk of HCMV transmission to the fetus in pregnant women receiving immunosuppressive agents is unknown. We describe two cases of pregnant women with evidence of pre-conception HCMV protective immunity receiving azathioprine for ulcerative colitis or systemic lupus erythematosus. Both women reactivated the HCMV and transmitted the infection to the fetuses. One newborn showed unilateral hearing deficits and brain abnormalities while the other was asymptomatic. The mother of the symptomatic newborn had low levels of total and HCMV-specific blood CD4+ T cells. Women receiving immunosuppressive agents deserve information about the risk of HCMV congenital infection and should be monitored for HCMV infection during pregnancy. Their newborns should be screened for HCMV congenital infection.
- Published
- 2020