Congenital Anomaly of Central Nervous System Associated with Antenatal Coinfection with Cytomegalovirus and Toxoplasma: Clinical Case

Background. The development of central nervous system (CNS) malformations may occur due to antenatal infection. Specific pathomorphological changes in CNS structures require further study. Clinical Case Description. The autopsy morphological study of the brain of a child who had antenatal toxoplasma...

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Main Authors: Natalia E. Gimaldinova, Yevgenia N. Ignatieva, Olga V. Vorobyova, Lyubov A. Lyubovtseva
Format: Article
Language:English
Published: "Paediatrician" Publishers LLC 2020-08-01
Series:Вопросы современной педиатрии
Subjects:
Online Access:https://vsp.spr-journal.ru/jour/article/view/2411
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author Natalia E. Gimaldinova
Yevgenia N. Ignatieva
Olga V. Vorobyova
Lyubov A. Lyubovtseva
author_facet Natalia E. Gimaldinova
Yevgenia N. Ignatieva
Olga V. Vorobyova
Lyubov A. Lyubovtseva
author_sort Natalia E. Gimaldinova
collection DOAJ
description Background. The development of central nervous system (CNS) malformations may occur due to antenatal infection. Specific pathomorphological changes in CNS structures require further study. Clinical Case Description. The autopsy morphological study of the brain of a child who had antenatal toxoplasma and cytomegalovirus infections and who died at the age of 2 years was performed. Thickening of the pia mater with cloudy surface due to edema and focal sclerosis, generalized thrombosis of superior sagittal sinus, sinus rectus and sinus transverses, absence of corpus callosum, major commissural fibers, opened third ventricle and vermis of cerebellum agenesia, as well as mixed forms of obstructive hydrocephalus were revealed. Diffuse gliosis with glial cysts in the periventricular zones were revealed at histological examination of the alba. Pseudocysts filled with toxoplasms were identified in the cysts’ wall. Signs of productive vasculitis were noted. Comparison of pathomorphological changes in the brain and internal organs with anamnestic data of the patient (toxoplasma and cytomegalovirus infection during recent pregnancy, brain abnormality of the fetus on the second ultrasound screening at 21–22 weeks of gestation) and the results of histological examination of placenta was carried out to prove the correlation of antenatal infection with the development of brain anomalies. Pathognomonic signs of cytomegalovirus infection and toxoplasmosis were revealed in the placenta: cytomegalic cells, vascular thrombosis, white infarcts, fibrinoid necrosis of basal lamina, placental hypoplasia. Toxoplasmic cysts were detected in chorionic villae stroma, parietal thophoblast, amnion, decidual tissue. Conclusion. Antenatal viral-parasitic infection may be the cause of brain anomalies of the fetus. However, the child had no specific signs of cytomegalovirus infection (such as cytomegalic cells — owl eye cells), even when the placenta had pathomorphological changes typical for this infection. It can be assumed that the development of brain anomaly in this child could be associated with toxoplasma infection.
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spelling doaj.art-d5d56b2c173c4624b7e52582a35d24e42023-09-03T10:32:30Zeng"Paediatrician" Publishers LLCВопросы современной педиатрии1682-55271682-55352020-08-0119320721310.15690/vsp.v19i3.21161882Congenital Anomaly of Central Nervous System Associated with Antenatal Coinfection with Cytomegalovirus and Toxoplasma: Clinical CaseNatalia E. Gimaldinova0Yevgenia N. Ignatieva1Olga V. Vorobyova2Lyubov A. Lyubovtseva3Чувашский государственный университет им. И.Н. УльяноваЧувашский государственный университет им. И.Н. УльяноваЧувашский государственный университет им. И.Н. УльяноваЧувашский государственный университет им. И.Н. УльяноваBackground. The development of central nervous system (CNS) malformations may occur due to antenatal infection. Specific pathomorphological changes in CNS structures require further study. Clinical Case Description. The autopsy morphological study of the brain of a child who had antenatal toxoplasma and cytomegalovirus infections and who died at the age of 2 years was performed. Thickening of the pia mater with cloudy surface due to edema and focal sclerosis, generalized thrombosis of superior sagittal sinus, sinus rectus and sinus transverses, absence of corpus callosum, major commissural fibers, opened third ventricle and vermis of cerebellum agenesia, as well as mixed forms of obstructive hydrocephalus were revealed. Diffuse gliosis with glial cysts in the periventricular zones were revealed at histological examination of the alba. Pseudocysts filled with toxoplasms were identified in the cysts’ wall. Signs of productive vasculitis were noted. Comparison of pathomorphological changes in the brain and internal organs with anamnestic data of the patient (toxoplasma and cytomegalovirus infection during recent pregnancy, brain abnormality of the fetus on the second ultrasound screening at 21–22 weeks of gestation) and the results of histological examination of placenta was carried out to prove the correlation of antenatal infection with the development of brain anomalies. Pathognomonic signs of cytomegalovirus infection and toxoplasmosis were revealed in the placenta: cytomegalic cells, vascular thrombosis, white infarcts, fibrinoid necrosis of basal lamina, placental hypoplasia. Toxoplasmic cysts were detected in chorionic villae stroma, parietal thophoblast, amnion, decidual tissue. Conclusion. Antenatal viral-parasitic infection may be the cause of brain anomalies of the fetus. However, the child had no specific signs of cytomegalovirus infection (such as cytomegalic cells — owl eye cells), even when the placenta had pathomorphological changes typical for this infection. It can be assumed that the development of brain anomaly in this child could be associated with toxoplasma infection.https://vsp.spr-journal.ru/jour/article/view/2411внутриутробная инфекцияврожденная пневмониязадержка внутриутробного развитияврожденные пороки развитияцентральная нервная систематоксоплазмозагенезияглиальные кистыпсевдоцисты
spellingShingle Natalia E. Gimaldinova
Yevgenia N. Ignatieva
Olga V. Vorobyova
Lyubov A. Lyubovtseva
Congenital Anomaly of Central Nervous System Associated with Antenatal Coinfection with Cytomegalovirus and Toxoplasma: Clinical Case
Вопросы современной педиатрии
внутриутробная инфекция
врожденная пневмония
задержка внутриутробного развития
врожденные пороки развития
центральная нервная система
токсоплазмоз
агенезия
глиальные кисты
псевдоцисты
title Congenital Anomaly of Central Nervous System Associated with Antenatal Coinfection with Cytomegalovirus and Toxoplasma: Clinical Case
title_full Congenital Anomaly of Central Nervous System Associated with Antenatal Coinfection with Cytomegalovirus and Toxoplasma: Clinical Case
title_fullStr Congenital Anomaly of Central Nervous System Associated with Antenatal Coinfection with Cytomegalovirus and Toxoplasma: Clinical Case
title_full_unstemmed Congenital Anomaly of Central Nervous System Associated with Antenatal Coinfection with Cytomegalovirus and Toxoplasma: Clinical Case
title_short Congenital Anomaly of Central Nervous System Associated with Antenatal Coinfection with Cytomegalovirus and Toxoplasma: Clinical Case
title_sort congenital anomaly of central nervous system associated with antenatal coinfection with cytomegalovirus and toxoplasma clinical case
topic внутриутробная инфекция
врожденная пневмония
задержка внутриутробного развития
врожденные пороки развития
центральная нервная система
токсоплазмоз
агенезия
глиальные кисты
псевдоцисты
url https://vsp.spr-journal.ru/jour/article/view/2411
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AT olgavvorobyova congenitalanomalyofcentralnervoussystemassociatedwithantenatalcoinfectionwithcytomegalovirusandtoxoplasmaclinicalcase
AT lyubovalyubovtseva congenitalanomalyofcentralnervoussystemassociatedwithantenatalcoinfectionwithcytomegalovirusandtoxoplasmaclinicalcase