Cerebrospinal fluid immunoglobulins are increased in neonates exposed to Zika virus during foetal life
Objective: To compare immunoglobulin levels in cerebrospinal fluid (CSF) of neonates exposed to Zika virus (ZIKV) during foetal life (cases) with levels in CSF of control neonates. Methods: We identified 16 neonates who underwent lumbar puncture (LP), during the ZIKV epidemic (December/2015 to March/2016) whose mothers reported ZIKV clinical symptoms during gestation (cases). Congenital microcephaly was defined as head circumference ≤31.9 cm (boys) and ≤31.5 cm (girls) for term neonates, or ≤2 standard deviations below the mean for premature (<37 weeks) neonates. Subsequently, we identified neonates who underwent LP in the same lab and fulfilled criteria to be controls: age ≤4 days, CSF white blood cell count ≤8/mm3, CSF protein ≤132 mg/dL, CSF red blood cell count ≤1,000/mm3, neither central nervous system illness, nor congenital infection, nor microcephaly. CSF immunoglobulin concentrations were measured by mass spectrometry. Results: 13 controls were included. IgM, IgA, IgG, IgK, and IgL were significantly higher among cases (p < 0.001). Eight (50%) ZIKV exposed infants had congenital microcephaly. These showed the strongest immunoglobulin elevation of the IgM and IgA classes. Conclusion: Neonates exposed to ZIKV infection during gestation present with elevated distinct immunoglobulins in CSF, both in cases that developed microcephaly and in cases that did not.
|Cerebrospinal fluid, Congenital Zika virus infection, Immunoglobulins, Mass spectrometry, Microcephaly|
|Journal of Infection|
|Organisation||Department of Neurology|
Nascimento-Carvalho, G.C. (Gustavo C.), van Duijn, M.M, Ramos, C.L. (Clara L.), Vilas-Boas, A.-L. (Ana-Luisa), Moreno-Carvalho, O.A. (Otávio A.), Zeneyedpour, L, … Nascimento-Carvalho, C.M. (Cristiana M.). (2020). Cerebrospinal fluid immunoglobulins are increased in neonates exposed to Zika virus during foetal life. Journal of Infection. doi:10.1016/j.jinf.2020.01.006