BACKGROUND: In 1941, a Sydney ophthalmologist, Norman McAlister Gregg, correctly identified the link between congenital cataracts in infants and maternal rubella early in pregnancy. Fifty of Gregg's subjects with congenital rubella, born in 1939-1944, were reviewed in 1967 and again in 1991. We reviewed this cohort in 2000-2001, 60 years after their intrauterine infection. METHODS: The subjects underwent full clinical assessment, plus pathology tests, an ophthalmological and cardiological review (including electrocardiography and echocardiography) and HLA histocompatibility testing. RESULTS: Since they were first seen in 1967, 10 have died (cardiovascular causes [4], malignant disease [4], AIDS [1], and hepatitis C-related cirrhosis [1]). All surviving men came for review (19) and 13 women (eight women declined). Echocardiography showed mild aortic valve sclerosis in 68%. The prevalence of diabetes (22%), thyroid disorders (19%), early menopause (73%) and osteoporosis (12.5%) was increased compared with the Australian population; 41% had undetectable levels of rubella antibodies. The frequency of HLA-A1 (44%) and HLA-B8 (34%) antigens was increased, and the haplotype HLA-A1, B8, DR3, said to be highly associated with many autoimmune conditions, was present in 25%. CONCLUSIONS: This cohort of people with congenital rubella has illuminated our understanding of viral teratogenesis.
BACKGROUND: In 1941, a Sydney ophthalmologist, Norman McAlister Gregg, correctly identified the link between congenital cataracts in infants and maternal rubella early in pregnancy. Fifty of Gregg's subjects with congenital rubella, born in 1939-1944, were reviewed in 1967 and again in 1991. We reviewed this cohort in 2000-2001, 60 years after their intrauterine infection. METHODS: The subjects underwent full clinical assessment, plus pathology tests, an ophthalmological and cardiological review (including electrocardiography and echocardiography) and HLA histocompatibility testing. RESULTS: Since they were first seen in 1967, 10 have died (cardiovascular causes [4], malignant disease [4], AIDS [1], and hepatitis C-related cirrhosis [1]). All surviving men came for review (19) and 13 women (eight women declined). Echocardiography showed mild aortic valve sclerosis in 68%. The prevalence of diabetes (22%), thyroid disorders (19%), early menopause (73%) and osteoporosis (12.5%) was increased compared with the Australian population; 41% had undetectable levels of rubella antibodies. The frequency of HLA-A1 (44%) and HLA-B8 (34%) antigens was increased, and the haplotype HLA-A1, B8, DR3, said to be highly associated with many autoimmune conditions, was present in 25%. CONCLUSIONS: This cohort of people with congenital rubella has illuminated our understanding of viral teratogenesis.
Authors: Terri B Hyde; Helena Keico Sato; LiJuan Hao; Brendan Flannery; Qi Zheng; Kathleen Wannemuehler; Flávia Helena Ciccone; Heloisa de Sousa Marques; Lily Yin Weckx; Marco Aurélio Sáfadi; Eliane de Oliveira Moraes; Marisa Mussi Pinhata; Jaime Olbrich Neto; Maria Cecilia Bevilacqua; Alfredo Tabith Junior; Tatiana Alves Monteiro; Cristina Adelaide Figueiredo; Jon K Andrus; Susan E Reef; Cristiana M Toscano; Carlos Castillo-Solorzano; Joseph P Icenogle Journal: J Infect Dis Date: 2014-10-31 Impact factor: 5.226
Authors: Sidra Ishaque; Mohammad Yawar Yakoob; Aamer Imdad; Robert L Goldenberg; Thomas P Eisele; Zulfiqar A Bhutta Journal: BMC Public Health Date: 2011-04-13 Impact factor: 3.295
Authors: Michael B A Oldstone; Kurt H Edelmann; Dorian B McGavern; Justin T Cruite; Megan J Welch Journal: PLoS Pathog Date: 2012-11-29 Impact factor: 6.823