Congenital microcephaly is not an optimal screening method for congenital Zika virus syndrome, because it may not accompany other evident and preceding brain findings; microcephaly could be an endpoint of the disease that results from progressive changes that are related to brain volume loss. Long-term studies are needed to understand the clinical and developmental relevance of these findings.
ika virus (ZIKV) is a neurotropic flavivirus spread to humans by Aedes genus mosquitos. Zika virus was first isolated in the Zika Forest in Uganda in a nonhuman primate in 1947. 1,2 Five years later, Nigeria reported the first cases of ZIKV transmission to humans, and subsequent ZIKV outbreaks have been reported outside Africa. [1][2][3] The first autochthonous case was confirmed in 2015 in Brazil, with a subsequent increase in the number of cases. This event coincided with reports of newborns with microcephaly, congenital malformations, and neurologic syndromes. 1,2 The spread of ZIKV to other parts of Latin America, the Caribbean, and the United States brought epidemiologic concern because of the clinical manifestations, including those associated with congenital Zika syndrome (CZS). [4][5][6] Although microcephaly is considered to be the characteristic feature of CZS, other central nervous system abnormalities and ocular findings have been described as part of this entity. [7][8][9][10] Despite having clinical evidence of the association between CZS and ocular findings, [11][12][13][14][15][16] only a few studies 17,18 have identified the presence of ZIKV in mouse ocular tissues and cultured human cells. Ritter et al 19 described the presence of ZIKV antigen within the neural retina in 1 case of CZS by immunohistochemical analysis, but the histopathologic findings were not described. The only study to date that has provided valuable clinical information regarding the retinal layers affected in CZS in human eyes was performed using optical IMPORTANCE Congenital Zika syndrome (CZS) is known to be associated with severe malformations in newborns. Although microcephaly is the hallmark of this disease, the ocular findings are important given the severe visual impairment that has been observed in these patients. Regardless of the increased number of CZS cases reported, to date, no studies have described the ocular histopathologic findings of this entity.OBJECTIVES To evaluate the presence of Zika virus (ZIKV) antigens and describe the associated ocular histopathologic features of 4 cases of CZS.
El Hidrops fetal es la acumulación anormal de líquido en al menos 2 compartimientos fetales. Su origen puede ser inmune o no inmune. El parvovirus B19 es responsable de una parte importante de los casos de hidrops no inmune. El pronóstico fetal ante esta entidad, es malo, y presenta alta mortalidad. Se presentar un caso clínico de una gestante con un feto afectado por hidrops no inmune secundario a anemia severa, causada por infección fetal por parvovirus B19, manejado mediante transfusión sanguínea fetal intrauterina.
(Am J Obstet Gynecol. 2018;218:440.e1–e36)
Perinatal infection of women with Zika virus (ZIKV) results in congenital ZIKV syndrome (CZS) in 10% of cases. CZS results in brain and ocular malformations, microcephaly, congenital deafness, limb contractures, and arthrogryposis. However, there is lack of consensus regarding the diagnosis and prognosis of CZS, and screening recommendations for the detection of fetuses affected by CZS range from screening for microcephaly alone to a full neuroanatomic evaluation. The objectives of the current study were (1) to assess the prevalence of microcephaly and other brain findings in infected and affected fetuses and infants, (2) to compare these findings with other congenital ZIKV series reported to date, and (3) to provide quantitative measures of magnetic resonance imaging (MRI) of fetal and infant brain imaging.
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