The Immunoglobulins in Congenital Rubella

Maternal rubella and its effect on the foetus.

“…At the time of birth, IgM had appeared in the serum of rubella-infected infants but not in the normal infants (Alford, 1965). Quantitative estimation of the immunoglobulins in 22 cases of congenital rubella in the first year of life carried out by Soothill et al (1966) confirmed these qualitative findings, that production of rubella antibody probably begins in utero and is predominantly IgM in character. The IgM was abnormally high in nearly all the children studied, particularly in those from whom virus was isolated.…”

“…The development of microcephaly, mental retardation, and electroencephalographic records (Rudolph et al, 1965;Singleton et al, 1966) Other manifestations. These include anaemia, both haemolytic and hypoplastic (Cooper et al, 1965a;Horstmann et al, 1965a); interstitial pneumonitis and splenic fibrosis (Plotkin et al, 1965b), rubella exanthem and lymphadenopathy (Hambidge et al, 1966), and hypogammaglobulinaemia (Soothill, Hayes, and Dudgeon, 1966). Unusual dermatoglyphic findings associated with rubella syndrome have been reported by Achs, Harper, and Siegel (1966), but these observations require further study.…”

Pathology of congenital rubella in Jamaica.

“…In one case, they were able to demonstrate the presence of emboli of what appeared to be chorionic cell detritus in the umbilical vein and an arteriole of the brain. Human chimeras have been described by Taylor and Polani (1965) and Kadowaki, Thompson, Zuelzer, Woolley, Brough, and Gruber (1965) The inumunoglobulins at 1 year of age were of a similar order to those found by Soothill et al (1966) in 4 of their cases of rubella; that is, low IgG level and raised IgM. However, the loss of lymphoid tissue in this case was much more striking, especially in the thymus and alimentary tract, than in our cases of congenital rubella.…”

“…In spite of this, there are high antibody levels in the blood (Plotkin, Dudgeon, and Ramsay, 1963). In addition, there is evidence of immunological disturbance, as shown in levels of IgM and IgG (Bellanti, Artenstein, Olson, Buescher, Luhrs, and Milstead, 1965;Soothill, Hayes, and Dudgeon, 1966). These facts, combined with a picture of antenatal and postnatal growth retardation, thrombocytopenia, susceptibility to infections, especially pneumonia and diarrhoea, lymphoid hyperplasia, splenic enlargement and later atrophy, liver, myocardial, renal, and brain damage, and thymic atrophy suggest two possibilities.…”

Immunoglobulin levels in maternal and neonatal sera from normal and abnormal pregnancies

“…It would be of interest to know the contribution of the fetus to IgG levels in cases of NTD, which could be done by allotype analysis. Fetal immunodefficiency, such as can occur following intrauterine infection with rubella [26,27]; or as a result of a response to paternal allotypic determinants, is unlikely to be a major cause of the low neonatal IgG levels in NTD. Other factors such as the extent of placental transfer of maternal IgG and its disappearance from the fetal circulation are more likely explanations.…”