Psychiatric manifestations of congenital rubella syndrome: A case report and review of literature

Abstract

Neurodevelopmental disorders are known to have varied etiology. Among known etiologic causes, congenital rubella syndrome (CRS) is reported to be one of the infections associated with neurodevelopmental disorders. CRS has been reported to be associated with large number of psychiatric manifestation. However, data from developing countries on psychiatric manifestations of CRS are nonexistent. In this report, we present the case of a 7-year-old boy, who presented with mental retardation, atypical autism, and attention deficit hyperactivity disorder. Since birth, the child was found to have congenital cardiac defects and was found to have bilateral profound sensorineural hearing loss since the age of 6 months. Magnetic resonance imaging showed multifocal symmetrical T2/fluid attenuated inversion recovery hyperintensities in bilateral cerebral hemisphere suggestive of sequelae of congenital rubella infection.

Hospital based surveillance of congenital rubella syndrome cases in the pre-vaccine era in Amhara Regional State, Ethiopia: A base line information for the country

“…Some of the infants with laboratory confirmed CRS cases had only single clinical manifestation but some others had multiple clinical symptoms at a time. This variation in the clinical presentations can be explained that a child might have multiple birth defects and some of these birth defects would be recognized immediately after birth and some others might be revealed after months or years [ 53 ]. Furthermore, as many as 50% of infants with CRS may appear normal at birth [ 54 ], but they will have late-onsets of congenital rubella manifestations.…”

Increased Incidence of Mental Disorders in Children with Cataract: Findings from a Population-based Study

“…Some somatic comorbidities were potential confounders (disease confounders) as either the disease itself or its treatment may increase the risk of cataract as well as mental disorders. This group included: interstitial lung disease (J84.9 + J84.8 + J84.1) due to treatment with high doses of prednisolone 33,34 , congenital rubella syndrome (P35.0 + B06.0 + B06.8 + B06.9) [15][16][17] , congenital cytomegalovirus infection (B25.0 + B25.1 + B25.2 + B25.8 + B25.9 + P35.1) 15,18 , degenerative disease of the nervous system (G31 + G31.1 + G31.9) 35,36 and cancer in brain or meninges due to radiation therapy (C70-72.9 + C76.0 + C69) [37][38][39] , microcephaly (Q02.9), megalencephaly (Q04.5), Smith-Lemli-Opitz' syndrome (Q87.1I), trisomy 21 (Q90.0-90.2), Down's syndrome (Q90 + Q90.9) and autosomal trisomies (Q92-92.9). Severe somatic comorbidities in the cataract group are listed in Supplementary Table 2.…”

“…Severe somatic disease may be directly linked to both development of cataract and presence of mental disease [14][15][16][17][18][19][20] . We found a doubling of the risk of unspecific developmental delay disorder in children with cataract also in analyses adjusting for diseases with known neuro-developmental comorbidity and diseases in which the treatment involves potential adverse neuro-developmental exposures 33,34,[37][38][39] .…”

“…Visually disturbing cataracts can be removed by surgery 10 but prolonged and intensive visual and optical rehabilitation is required 11,12 . Childhood cataract can occur isolated or can be seen in combination with somatic comorbidities 13 that may be associated with neurodevelopmental disorders [14][15][16][17][18][19][20] . Most cases of childhood cataract occur in early childhood 21 , which is also the period of onset of several childhood mental disorders, in particular neurodevelopmental disorders 22 .…”

Lessons from ten years searching the Congenital Rubella Syndrome (CRS) cases in young population of a developing country: Tehran; Iran.

“…The diagnosis of CRS (congenital rubella syndrome) is considered with the classic clinical triad of cataracts, heart disease and hearing loss; although, many neonates have only one symptom at presentation or will progress symptoms during infancy (2). Maternal infection with rubella in the rst trimester of pregnancy can result in developmental abnormalities in fetus such as hearing loss, heart abnormalities, impaired vision, and mental retardation (2). About 50% of symptomatic newborns with congenital rubella have hearing loss which may end in cochlear implantation.…”