CYTOMEGALOVIRUS INFECTION AND CONGENITAL HYPOTHYROIDISM: POSSIBLE ASSOCIATION

Abstract

Background: Congenital hypothyroidism (CH) is the most common congenital endocrine disease with reported high prevalence of associated congenital anomalies which are also present in case of congenital cytomegalovirus (cCMV) infection.

Subjects and methods: We present two cases of newborns cCMV infection with CH. In the first case thyroid agenesis was diagnosed and cCMV infection was also confirmed for the hypotonia persistence after L-thyroxine treatment. In the second case thyroid dyshormonogenesis was diagnosed with maternal CMV serological conversion in the first trimester of gestation and confirmed post-neonatal infection. Incidence of CH has increased in the Italian region of Piedmont in the years 2014-2019 up to 1:1090 with higher incidence of cCMV infection in the babies with diagnosis of CH (12/1000 vs. 5-7/1000 in the newborns without CH). To our knowledge, no data on the association of cCMV infection with a CH condition have been reported in the literature to date.

Conclusions: The described cases could be useful to alert caregivers in case of maternal seroconversion to avoid maternal and foetal hypothyroidism. On the other hand, when the clinical condition of newborns with CH diagnosis do not improve after l-thyroxine treatment, it might be important to consider cCMV infection.

Keywords: Congenital Cytomegalovirus infection; Congenital hypothyroidism; association; neonatal.

Figure 1

Cerebral ultrasound showing bilateral diffuse periventricular hyperechogenic areas and signs of vasculitis in the thalamic blood vessels.

Figure 2

Brain MRI showing hypointensity of white matter in T2 sequences (left) and hyperintensity in T1 images (right) as possible outcomes of cerebral hypoxia or CMV infection.