Prenatal management of congenital human cytomegalovirus infection in seropositive pregnant patients treated with azathioprine: Diagnostics

P.I. Cavoretto, C. Fornara, C. Baldoli, A. Arossa, M. Furione, M. Candiani, P.R. Querini, G. Barera, A. Poloniato, G. Gaeta, A. Spinillo, D. Lilleri

Research output: Contribution to journalArticlepeer-review

Abstract

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. © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
Original languageEnglish
JournalDiagn.
Volume10
Issue number8
DOIs
Publication statusPublished - 2020

Keywords

  • Azathioprine
  • Congenital cytomegalovirus infection
  • Fetal MRI
  • Pregnancy
  • Ultrasound
  • acetylsalicylic acid
  • azathioprine
  • CD4 antigen
  • CD8 antigen
  • ganciclovir
  • hydroxychloroquine
  • immunoglobulin G
  • valganciclovir
  • virus DNA
  • adult
  • Article
  • asymptomatic infection
  • brain malformation
  • case report
  • CD4+ T lymphocyte
  • CD8+ T lymphocyte
  • clinical article
  • controlled study
  • cytomegalovirus infection
  • female
  • fetus
  • fetus echography
  • fetus risk
  • hearing impairment
  • human
  • Human cytomegalovirus
  • immunity
  • immunosuppressive treatment
  • infection risk
  • newborn
  • nonhuman
  • nuclear magnetic resonance imaging
  • pregnant woman
  • prenatal period
  • serology
  • systemic lupus erythematosus
  • ulcerative colitis
  • virus reactivation
  • virus transmission

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