Gregg's congenital rubella patients 60 years later.
BACKGROUND
In 1941, a Sydney ophthalmologist, Norman McAlister Gregg, correctly identified the link between congenital cataracts in infants and maternal rubella early in pregnancy. Fifty of Gregg's subjects with congenital rubella, born in 1939-1944, were reviewed in 1967 and again in 1991. We reviewed this cohort in 2000-2001, 60 years after their intrauterine infection.


METHODS
The subjects underwent full clinical assessment, plus pathology tests, an ophthalmological and cardiological review (including electrocardiography and echocardiography) and HLA histocompatibility testing.


RESULTS
Since they were first seen in 1967, 10 have died (cardiovascular causes [4], malignant disease [4], AIDS [1], and hepatitis C-related cirrhosis [1]). All surviving men came for review (19) and 13 women (eight women declined). Echocardiography showed mild aortic valve sclerosis in 68%. The prevalence of diabetes (22%), thyroid disorders (19%), early menopause (73%) and osteoporosis (12.5%) was increased compared with the Australian population; 41% had undetectable levels of rubella antibodies. The frequency of HLA-A1 (44%) and HLA-B8 (34%) antigens was increased, and the haplotype HLA-A1, B8, DR3, said to be highly associated with many autoimmune conditions, was present in 25%.


CONCLUSIONS
This cohort of people with congenital rubella has illuminated our understanding of viral teratogenesis.
Forrest
Jill M
JM
Royal Alexandra Hospital for Children, Locked Bag 4001, Westmead, NSW. jillf@chw.edu.au
Turnbull
Fiona M
FM
Sholler
Gary F
GF
Hawker
Richard E
RE
Martin
Frank J
FJ
Doran
Trevor T
TT
Burgess
Margaret A
MA
D000914:Antibodies, Viral / Q000032:analysis; D001315:Australia; D002318:Cardiovascular Diseases / Q000150:complications; D015331:Cohort Studies; D048909:Diabetes Complications; D005128:Eye Diseases / Q000150:complications; D005260:Female; D005500:Follow-Up Studies; D006680:HLA Antigens / Q000032:analysis; D049673:History, 20th Century; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D011788:Quality of Life; D012410:Rubella Syndrome, Congenital / Q000150:complications / Q000175:diagnosis* / Q000266:history / Q000276:immunology; D012412:Rubella virus / Q000276:immunology
D000914:Antibodies, Viral; D006680:HLA Antigens