Congenital rubella syndrome natural history: Difference between revisions

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Latest revision as of 21:04, 29 July 2020

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Dima Nimri, M.D. [2]

Overview

Congenital rubella syndrome can cause serious birth defects and the prognosis depends on the severity of the problem. Heart defects can be corrected but neurological damage is permanent.^[1]^[2]^[3]^[4]^[5]^[6]

Natural History

If malformations associated with congenital rubella syndrome are not addressed, infants may end-up blind, deaf, and with severe mental deficits.

Complications

Maternal infection with rubella early in pregnancy can result in severe consequences on the fetus, which include spontaneous abortion, stillbirth, IUGR, and congenital rubella syndrome.^[7] Complications of congenital rubella syndrome itself include several birth defects, which can result in early and late complications.^[1]^[2]^[3]^[4]^[5]^[6]

Early Complications

Organ System Involved	Complication
HEENT	Microcephaly Congenital cataracts Sensorineural hearing loss
Neurological	Mental retardation Encephalitis
Cardiac	VSD PDA Coarctation of the aorta Pulmonary artery stenosis

Late Complications

Organ System Involved	Complication
HEENT	Glaucoma
Endocrine	Non-insulin dependent diabetes mellitus (NIDDM) Thyroid dysfunction, thyroiditis
Neurological/ Psychiatric	Progressive pan-encephalitis Autism Non-affective psychosis

Prognosis

The prognosis of congenital rubella syndrome depends on the severity of cardiac and neurological malformations. It is estimated that congenital rubella syndrome has a mortality rate of 20%.^[8] In addition, congenital rubella syndrome is associated with various long-term complications^[1]^[2]^[3]^[4]^[5]^[6], which affect the quality of life of individuals.

References

↑ ^1.0 ^1.1 ^1.2 De Santis M, Cavaliere AF, Straface G, Caruso A (2006). "Rubella infection in pregnancy". Reprod. Toxicol. 21 (4): 390–8. doi:10.1016/j.reprotox.2005.01.014. PMID 16580940.
↑ ^2.0 ^2.1 ^2.2 Lambert N, Strebel P, Orenstein W, Icenogle J, Poland GA (2015). "Rubella". Lancet. 385 (9984): 2297–307. doi:10.1016/S0140-6736(14)60539-0. PMC 4514442. PMID 25576992.
↑ ^3.0 ^3.1 ^3.2 Webster WS (1998). "Teratogen update: congenital rubella". Teratology. 58 (1): 13–23. doi:10.1002/(SICI)1096-9926(199807)58:1<13::AID-TERA5>3.0.CO;2-2. PMID 9699240.
↑ ^4.0 ^4.1 ^4.2 Neu N, Duchon J, Zachariah P (2015). "TORCH infections". Clin Perinatol. 42 (1): 77–103, viii. doi:10.1016/j.clp.2014.11.001. PMID 25677998.
↑ ^5.0 ^5.1 ^5.2 Ajij M, Nangia S, Dubey BS (2014). "Congenital rubella syndrome with blueberry muffin lesions and extensive metaphysitis". J Clin Diagn Res. 8 (12): PD03–4. doi:10.7860/JCDR/2014/10271.5293. PMC 4316306. PMID 25654000.
↑ ^6.0 ^6.1 ^6.2 Bouthry E, Picone O, Hamdi G, Grangeot-Keros L, Ayoubi JM, Vauloup-Fellous C (2014). "Rubella and pregnancy: diagnosis, management and outcomes". Prenat. Diagn. 34 (13): 1246–53. doi:10.1002/pd.4467. PMID 25066688.
↑ Silasi M, Cardenas I, Kwon JY, Racicot K, Aldo P, Mor G (2015). "Viral infections during pregnancy". Am. J. Reprod. Immunol. 73 (3): 199–213. doi:10.1111/aji.12355. PMC 4610031. PMID 25582523.
↑ GREGG NM (1947). "Congenital defects associated with maternal rubella". Aust Hosp. 14 (11): 7–9. PMID 18914301.

Template:WH Template:WS

[pmid16580940-1] 1.0 ^1.1 ^1.2 De Santis M, Cavaliere AF, Straface G, Caruso A (2006). "Rubella infection in pregnancy". Reprod. Toxicol. 21 (4): 390–8. doi:10.1016/j.reprotox.2005.01.014. PMID 16580940.

[pmid25576992-2] 2.0 ^2.1 ^2.2 Lambert N, Strebel P, Orenstein W, Icenogle J, Poland GA (2015). "Rubella". Lancet. 385 (9984): 2297–307. doi:10.1016/S0140-6736(14)60539-0. PMC 4514442. PMID 25576992.

[pmid9699240-3] 3.0 ^3.1 ^3.2 Webster WS (1998). "Teratogen update: congenital rubella". Teratology. 58 (1): 13–23. doi:10.1002/(SICI)1096-9926(199807)58:1<13::AID-TERA5>3.0.CO;2-2. PMID 9699240.

[pmid25677998-4] 4.0 ^4.1 ^4.2 Neu N, Duchon J, Zachariah P (2015). "TORCH infections". Clin Perinatol. 42 (1): 77–103, viii. doi:10.1016/j.clp.2014.11.001. PMID 25677998.

[pmid25654000-5] 5.0 ^5.1 ^5.2 Ajij M, Nangia S, Dubey BS (2014). "Congenital rubella syndrome with blueberry muffin lesions and extensive metaphysitis". J Clin Diagn Res. 8 (12): PD03–4. doi:10.7860/JCDR/2014/10271.5293. PMC 4316306. PMID 25654000.

[pmid25066688-6] 6.0 ^6.1 ^6.2 Bouthry E, Picone O, Hamdi G, Grangeot-Keros L, Ayoubi JM, Vauloup-Fellous C (2014). "Rubella and pregnancy: diagnosis, management and outcomes". Prenat. Diagn. 34 (13): 1246–53. doi:10.1002/pd.4467. PMID 25066688.

[pmid25582523-7] Silasi M, Cardenas I, Kwon JY, Racicot K, Aldo P, Mor G (2015). "Viral infections during pregnancy". Am. J. Reprod. Immunol. 73 (3): 199–213. doi:10.1111/aji.12355. PMC 4610031. PMID 25582523.

[pmid18914301-8] GREGG NM (1947). "Congenital defects associated with maternal rubella". Aust Hosp. 14 (11): 7–9. PMID 18914301.

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@@ Line 1: / Line 1: @@
 __NOTOC__
-{{CMG}}
+{{CMG}}; {{AE}}{{DN}}
 {{Congenital rubella syndrome}}
 ==Overview==
-==Natural history==
+Congenital rubella syndrome can cause serious birth defects and the prognosis depends on the severity of the problem. Heart defects can be corrected but neurological damage is permanent.<ref name="pmid16580940">{{cite journal |vauthors=De Santis M, Cavaliere AF, Straface G, Caruso A |title=Rubella infection in pregnancy |journal=Reprod. Toxicol. |volume=21 |issue=4 |pages=390–8 |year=2006 |pmid=16580940 |doi=10.1016/j.reprotox.2005.01.014 |url=}}</ref><ref name="pmid25576992">{{cite journal |vauthors=Lambert N, Strebel P, Orenstein W, Icenogle J, Poland GA |title=Rubella |journal=Lancet |volume=385 |issue=9984 |pages=2297–307 |year=2015 |pmid=25576992 |pmc=4514442 |doi=10.1016/S0140-6736(14)60539-0 |url=}}</ref><ref name="pmid9699240">{{cite journal |vauthors=Webster WS |title=Teratogen update: congenital rubella |journal=Teratology |volume=58 |issue=1 |pages=13–23 |year=1998 |pmid=9699240 |doi=10.1002/(SICI)1096-9926(199807)58:1<13::AID-TERA5>3.0.CO;2-2 |url=}}</ref><ref name="pmid25677998">{{cite journal |vauthors=Neu N, Duchon J, Zachariah P |title=TORCH infections |journal=Clin Perinatol |volume=42 |issue=1 |pages=77–103, viii |year=2015 |pmid=25677998 |doi=10.1016/j.clp.2014.11.001 |url=}}</ref><ref name="pmid25654000">{{cite journal |vauthors=Ajij M, Nangia S, Dubey BS |title=Congenital rubella syndrome with blueberry muffin lesions and extensive metaphysitis |journal=J Clin Diagn Res |volume=8 |issue=12 |pages=PD03–4 |year=2014 |pmid=25654000 |pmc=4316306 |doi=10.7860/JCDR/2014/10271.5293 |url=}}</ref><ref name="pmid25066688">{{cite journal |vauthors=Bouthry E, Picone O, Hamdi G, Grangeot-Keros L, Ayoubi JM, Vauloup-Fellous C |title=Rubella and pregnancy: diagnosis, management and outcomes |journal=Prenat. Diagn. |volume=34 |issue=13 |pages=1246–53 |year=2014 |pmid=25066688 |doi=10.1002/pd.4467 |url=}}</ref>
+==Natural History==
+If [[malformations]] associated with congenital rubella syndrome are not addressed, infants may end-up [[blind]], [[deaf]], and with severe [[mental deficiency|mental deficits]].
 ==Complications==
-CRS can result in serious [[birth defect]]s such as:
+Maternal infection with [[rubella]] early in pregnancy can result in severe consequences on the fetus, which include [[spontaneous abortion]], [[stillbirth]], [[IUGR]], and congenital rubella syndrome.<ref name="pmid25582523">{{cite journal |vauthors=Silasi M, Cardenas I, Kwon JY, Racicot K, Aldo P, Mor G |title=Viral infections during pregnancy |journal=Am. J. Reprod. Immunol. |volume=73 |issue=3 |pages=199–213 |year=2015 |pmid=25582523 |pmc=4610031 |doi=10.1111/aji.12355 |url=}}</ref> Complications of congenital rubella syndrome itself include several birth defects, which can result in early and late complications.<ref name="pmid16580940">{{cite journal |vauthors=De Santis M, Cavaliere AF, Straface G, Caruso A |title=Rubella infection in pregnancy |journal=Reprod. Toxicol. |volume=21 |issue=4 |pages=390–8 |year=2006 |pmid=16580940 |doi=10.1016/j.reprotox.2005.01.014 |url=}}</ref><ref name="pmid25576992">{{cite journal |vauthors=Lambert N, Strebel P, Orenstein W, Icenogle J, Poland GA |title=Rubella |journal=Lancet |volume=385 |issue=9984 |pages=2297–307 |year=2015 |pmid=25576992 |pmc=4514442 |doi=10.1016/S0140-6736(14)60539-0 |url=}}</ref><ref name="pmid9699240">{{cite journal |vauthors=Webster WS |title=Teratogen update: congenital rubella |journal=Teratology |volume=58 |issue=1 |pages=13–23 |year=1998 |pmid=9699240 |doi=10.1002/(SICI)1096-9926(199807)58:1<13::AID-TERA5>3.0.CO;2-2 |url=}}</ref><ref name="pmid25677998">{{cite journal |vauthors=Neu N, Duchon J, Zachariah P |title=TORCH infections |journal=Clin Perinatol |volume=42 |issue=1 |pages=77–103, viii |year=2015 |pmid=25677998 |doi=10.1016/j.clp.2014.11.001 |url=}}</ref><ref name="pmid25654000">{{cite journal |vauthors=Ajij M, Nangia S, Dubey BS |title=Congenital rubella syndrome with blueberry muffin lesions and extensive metaphysitis |journal=J Clin Diagn Res |volume=8 |issue=12 |pages=PD03–4 |year=2014 |pmid=25654000 |pmc=4316306 |doi=10.7860/JCDR/2014/10271.5293 |url=}}</ref><ref name="pmid25066688">{{cite journal |vauthors=Bouthry E, Picone O, Hamdi G, Grangeot-Keros L, Ayoubi JM, Vauloup-Fellous C |title=Rubella and pregnancy: diagnosis, management and outcomes |journal=Prenat. Diagn. |volume=34 |issue=13 |pages=1246–53 |year=2014 |pmid=25066688 |doi=10.1002/pd.4467 |url=}}</ref>
+===Early Complications===
+{| class="wikitable"
+!Organ System Involved
+!Complication
+|-
+|HEENT
+|
+* [[Microcephaly]]
+* [[Congenital]] [[cataracts]]
+* [[Sensorineural hearing loss]]
+|-
+|Neurological
+|
+* [[Mental retardation]]
+* [[Encephalitis]]
+|-
+|Cardiac
+|
+* [[VSD]]
+* [[Patent ductus arteriosus|PDA]]
+* [[Coarctation of the aorta]]
+* [[Pulmonary artery stenosis]]
+|}
+===Late Complications===
+{| class="wikitable"
+!Organ System Involved
+!Complication
+|-
+|HEENT
+|[[Glaucoma]]
+|-
+|Endocrine
+|
+* [[Non-insulin dependent diabetes mellitus|Non-insulin dependent diabetes mellitus (NIDDM)]]
+* [[Thyroid]] dysfunction, [[thyroiditis]]
+|-
+|Neurological/ Psychiatric
+|
+* Progressive pan-encephalitis
+* [[Autism]]
+* Non-affective [[psychosis]]
+|}
-*Malformations of the [[heart]] (especially [[patent ductus arteriosus]]), [[eye]]s or [[brain]]
-*[[Deafness]]
-*[[Spleen]], [[liver]] or [[bone marrow]] problems (some of which may disappear shortly after birth)
-*[[Mental retardation]]
-*Small head size ([[microcephaly]])
-*Eye defects
-*Low birth weight
-*[[Thrombocytopenic purpura]]
-*[[Hepatomegaly]]
 ==Prognosis==
-*The outcome for a child with congenital rubella depends on the severity of problems present.
+The prognosis of congenital rubella syndrome depends on the severity of [[cardiac]] and [[neurological]] [[malformations]]. It is estimated that congenital rubella syndrome has a mortality rate of 20%.<ref name="pmid18914301">{{cite journal |vauthors=GREGG NM |title=Congenital defects associated with maternal rubella |journal=Aust Hosp |volume=14 |issue=11 |pages=7–9 |year=1947 |pmid=18914301 |doi= |url=}}</ref> In addition, congenital rubella syndrome is associated with various long-term complications<ref name="pmid16580940">{{cite journal |vauthors=De Santis M, Cavaliere AF, Straface G, Caruso A |title=Rubella infection in pregnancy |journal=Reprod. Toxicol. |volume=21 |issue=4 |pages=390–8 |year=2006 |pmid=16580940 |doi=10.1016/j.reprotox.2005.01.014 |url=}}</ref><ref name="pmid25576992">{{cite journal |vauthors=Lambert N, Strebel P, Orenstein W, Icenogle J, Poland GA |title=Rubella |journal=Lancet |volume=385 |issue=9984 |pages=2297–307 |year=2015 |pmid=25576992 |pmc=4514442 |doi=10.1016/S0140-6736(14)60539-0 |url=}}</ref><ref name="pmid9699240">{{cite journal |vauthors=Webster WS |title=Teratogen update: congenital rubella |journal=Teratology |volume=58 |issue=1 |pages=13–23 |year=1998 |pmid=9699240 |doi=10.1002/(SICI)1096-9926(199807)58:1<13::AID-TERA5>3.0.CO;2-2 |url=}}</ref><ref name="pmid25677998">{{cite journal |vauthors=Neu N, Duchon J, Zachariah P |title=TORCH infections |journal=Clin Perinatol |volume=42 |issue=1 |pages=77–103, viii |year=2015 |pmid=25677998 |doi=10.1016/j.clp.2014.11.001 |url=}}</ref><ref name="pmid25654000">{{cite journal |vauthors=Ajij M, Nangia S, Dubey BS |title=Congenital rubella syndrome with blueberry muffin lesions and extensive metaphysitis |journal=J Clin Diagn Res |volume=8 |issue=12 |pages=PD03–4 |year=2014 |pmid=25654000 |pmc=4316306 |doi=10.7860/JCDR/2014/10271.5293 |url=}}</ref><ref name="pmid25066688">{{cite journal |vauthors=Bouthry E, Picone O, Hamdi G, Grangeot-Keros L, Ayoubi JM, Vauloup-Fellous C |title=Rubella and pregnancy: diagnosis, management and outcomes |journal=Prenat. Diagn. |volume=34 |issue=13 |pages=1246–53 |year=2014 |pmid=25066688 |doi=10.1002/pd.4467 |url=}}</ref>, which affect the quality of life of individuals.
-*Heart defects can often be corrected.
-*Damage to the nervous system is permanent.
 ==References==
 {{Reflist|2}}
+{{WH}}
+{{WS}}
+[[Category:Emergency medicine]]
 [[Category:Disease]]
+[[Category:Up-To-Date]]
+[[Category:Infectious disease]]
 [[Category:Pediatrics]]
-[[Category:Neonatology]]
+[[Category:Obstetrics]]
-[[Category:Congenital disorders]]
-[[Category:Infectious disease]]
-[[Category:Syndromes]]
-[[Category:Needs content]]
-[[Category:Needs overview]]
-{{WH}}
-{{WS}}