Histological findings in foetuses congenitally infected by cytomegalovirus

Gabrielli, Liliana; Bonasoni, Maria Paola; Lazzarotto, Tiziana; Lega, Stefania; Santini, Donatella; Foschini, Maria Pia; Guerra, Brunella; Baccolini, Federica; Piccirilli, Giulia; Chiereghin, Angela; Petrisli, Evangelia; Gardini, Giorgio; Lanari, Marcello; Landini, Maria Paola

doi:10.1016/j.jcv.2009.09.026

« Previous Next »Journal of Clinical Virology
Volume 46, Supplement 4 , Pages S16-S21, December 2009

Histological findings in foetuses congenitally infected by cytomegalovirus

Liliana Gabrielli
- Operative Unit of Microbiology, St. Orsola Malpighi GH, University of Bologna, Italy
- Corresponding author at: Operative Unit of Microbiology, St. Orsola-Malpighi GH, Via Massarenti 9, 40138 Bologna, Italy. Tel.: +39 051 6364645; fax: +39 051 307397.
Maria Paola Bonasoni
- Operative Unit of Pathology, St. Maria Nuova Hospital, Reggio-Emilia, Italy
Tiziana Lazzarotto
- Operative Unit of Microbiology, St. Orsola Malpighi GH, University of Bologna, Italy
Stefania Lega
- Operative Unit of Pathology, St. Orsola Malpighi GH, University of Bologna, Italy
Donatella Santini
- Operative Unit of Pathology, St. Orsola Malpighi GH, University of Bologna, Italy
Maria Pia Foschini
- Department of Hematology, Oncology and Laboratory Medicine, Bellaria Hospital, Bologna, Italy
Brunella Guerra
- Department of Obstetrics and Gynecology, St. Orsola Malpighi GH, University of Bologna, Italy
Federica Baccolini
- Operative Unit of Microbiology, St. Orsola Malpighi GH, University of Bologna, Italy
Giulia Piccirilli
- Operative Unit of Microbiology, St. Orsola Malpighi GH, University of Bologna, Italy
Angela Chiereghin
- Operative Unit of Microbiology, St. Orsola Malpighi GH, University of Bologna, Italy
Evangelia Petrisli
- Operative Unit of Microbiology, St. Orsola Malpighi GH, University of Bologna, Italy
Giorgio Gardini
- Operative Unit of Pathology, St. Maria Nuova Hospital, Reggio-Emilia, Italy
Marcello Lanari
- Operative Unit of Preventive Paediatrics and Neonatology, St. Orsola Malpighi GH, University of Bologna, Italy
Maria Paola Landini
- Operative Unit of Microbiology, St. Orsola Malpighi GH, University of Bologna, Italy

Received 1 April 2009; received in revised form 17 September 2009; accepted 21 September 2009. published online 02 November 2009.

Abstract

Background

Congenital cytomegalovirus (CMV) infection is a major cause of central nervous system damage leading to sensorineural hearing loss, mental retardation and cerebral palsy.

Objectives

Identify the type of organ involvement and understand the histopathogenesis of damage in foetuses of women with a CMV-highly positive amniotic fluid.

Study design

34 foetuses with congenital CMV infection documented by prenatal diagnosis were studied. Three foetuses died in utero. The remaining pregnancies were electively terminated at 20–21 weeks gestation.

Results

Foetal organs positive for CMV antigens were: placenta (100%), pancreas (100%), lung (87%), kidney (87%), liver (71%), brain (55%) and heart (44%). Inflammatory infiltrate was almost always present in CMV-infected foetal organs and the severity of the inflammatory response was correlated with the organ damage. Brain damage with necrosis was observed in 33% (9/27) and a mild telencephalic leukoencephalopathy in 22% (6/27) of foetuses studied.

Conclusions

Focal necrosis was observed very frequently in organs such as pancreases, livers, hearts and kidneys. However the damage in these organs is likely to be resolved by parenchymal regeneration. Brain damage, which seems to be the results of a combined effect of viral infection, inflammatory infiltration and hypoxia due to severe placentitis, is less likely to be resolved because of the low regeneration ability of this organ.

Abbreviations: CMV, cytomegalovirus, PCR, polymerase chain reaction, EA, early antigen, LCA, leukocyte common antigen

Keywords: Cytomegalovirus, Congenital infection, Foetuses, Brain damage, Placenta, Inflammatory infiltration