Congenital cytomegalovirus infection via a re-infected mother with original antigenic sin: A case report
Congenital cytomegalovirus infection via a re-infected mother with original antigenic sin: A case report
复制标题
由具有原始抗原罪的母亲再次感染而导致的先天性巨细胞病毒感染：病例报告
DOI：
10.1016/j.ijid.2018.10.006
复制
发表时间：
2018
影响因子：
8.4
通讯作者：
Suzutani Tatsuo
中科院分区：
文献类型：
--
作者：
Koshizuka Tetsuo;Toriyabe Kuniaki;Sato Yuko;Ikuta Kazufumi;Ikeda Tomoaki;Suzutani Tatsuo
一名27岁孕妇谁是阳性的抗巨细胞病毒（CMV）抗体产下一个先天性CMV感染的新生儿在妊娠40周。根据株特异性血清学分析，这是能够确定两种类型的CMV糖蛋白H（gH），母亲只有抗gH（To）抗体，但新生儿出生后4周的抗gH（AD）和抗gH（To）抗体。由于新生儿在分娩后8个月时抗gH（To）IgG降低，因此认为这些抗体已作为母体抗体从母亲转移。即使在分娩后8个月，儿童的抗gH（AD）IgG水平仍保持不变。使用儿童的尿液标本，通过菌株特异性实时PCR确认CMV gH（AD）型菌株的先天性感染。另一方面，即使在分娩后8个月，在母体样本中也未检测到抗gH（AD）IgG。母亲只产生抗CMV病毒株的抗体，该病毒株被鉴定为原发感染，这是原始抗原的特征。
A 27-year-old pregnant woman who was positive for anti-cytomegalovirus (CMV) antibodies gave birth to a congenitally CMV-infected neonate at 40 weeks of gestation. According to strain-specific serological analysis, which is able to determine the two types of CMV glycoprotein H (gH), the mother possessed anti-gH(To) antibodies only, but the neonate possessed anti-gH(AD) and anti-gH(To) antibodies at 4 weeks after birth. As the anti-gH(To) IgG was decreased in the neonate at 8 months post-delivery, these antibodies are thought to have been transferred from the mother as maternal antibodies. The anti-gH(AD) IgG level was maintained in the child even after 8 months post-delivery. Congenital infection with a CMV gH(AD) type strain was confirmed by strain-specific real-time PCR using a urine specimen from the child. On the other hand, anti-gH(AD) IgG was not detected even after 8 months post-delivery in a maternal specimen. The mother only produced antibodies against the CMV strain identified as the primary infection, which is characteristic of original antigenic sin.