title: Congenital Rubella Syndrome: A Case Report on Changes in Viral Load and Rubella Antibody Titers.
abstract: To our knowledge, this is the first report of the use of real-time reverse transcription-polymerase chain reaction to assess changes in viral load in a patient with congenital rubella syndrome (CRS). Rubella-specific antibody titers were also determined. The patient was a male neonate born to a primipara with rubella infection at 10 weeks of gestation. He had no symptoms at birth, but rubella virus was detected in his pharynx, blood, and urine. His mental and physical development was normal for 1 year; however, he was diagnosed with deafness at 13 months of age. Thus, the patient was diagnosed with CRS. Rubella infection in the pharynx was almost constant until 5 months of age; however, it increased dramatically at 6 months of age. No infection was detected at 13 months. Rubella-specific immunoglobulin M titer was consistently low until 9 months of age and then decreased gradually until it became negative at 20 months of age. Rubella-specific immunoglobulin G titer was high at birth. However, it decreased at 3 months and increased again at 4 months. This titer peaked at ∼9 months and then decreased again at 13 months. This case shows that the period after the decline in maternal antibody titers, not the neonatal period, may be the most contagious period in patients with CRS.
authors.affiliation: Department of Pediatrics, Graduate School of Medicine, and adpa2753@chiba-u.jp.
authors.forename: Koo
authors.initials: K
authors.lastname: Nagasawa
authors.affiliation: Department of Infectious Diseases, Medical Mycology Research Center, Chiba University, Chiba-shi, Japan; and.
authors.forename: Naruhiko
authors.initials: N
authors.lastname: Ishiwada
authors.affiliation: Division of Virology, Chiba Prefectural Institute of Public Health, Chiba-shi, Japan.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Ogura
authors.affiliation: Division of Virology, Chiba Prefectural Institute of Public Health, Chiba-shi, Japan.
authors.forename: Tomoko
authors.initials: T
authors.lastname: Ogawa
authors.affiliation: Department of Infectious Diseases, Medical Mycology Research Center, Chiba University, Chiba-shi, Japan; and.
authors.forename: Noriko
authors.initials: N
authors.lastname: Takeuchi
authors.affiliation: Department of Pediatrics, Graduate School of Medicine, and.
authors.forename: Haruka
authors.initials: H
authors.lastname: Hishiki
authors.affiliation: Department of Pediatrics, Graduate School of Medicine, and.
authors.forename: Naoki
authors.initials: N
authors.lastname: Shimojo
mesh_terms: D000914:Antibodies, Viral / Q000097:blood*; D003638:Deafness / Q000175:diagnosis; D057210:Delayed Diagnosis; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D020133:Reverse Transcriptase Polymerase Chain Reaction; D012410:Rubella Syndrome, Congenital / Q000175:diagnosis / Q000821:virology*; D012412:Rubella virus / Q000276:immunology*; D019562:Viral Load
chemical_list: D000914:Antibodies, Viral