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Journal of Infectious Diseases and Medical Microbiology | Volume 3
November 11-12, 2019 | Singapore
International Conference on
3
rd
International Conference on
Pathology and Infectious Diseases
Pathology and Oncology Research
Joint Event
&
J Infectious Disease Med Microbiol
| Volume 3
Z
ika virus (ZIKV) is an emerging virus involved in recent
outbreaks in Brazil. The association between the virus
and Guillain-Barré syndrome (GBS) or congenital disorders
has raised a worldwide concern. In this work, we investigated
a rare Zika case, which was associated with GBS and
spontaneous retained abortion. Pregnant, black, 25 years old,
started with rash of limbs, itching and vomiting. Transvaginal
ultrasonography
evidenced
cephalic
circumference
suggesting 15 weeks of gestational age, lack of heartbeat, and
non-apparent activemovements, with diagnosis of death and
retained fetus (stillbirth). The patient evolved to ascending
and symmetrical flaccid tetraparesis, paresthesia, areflexia,
presenting hands with pendular movement, disautonomia
and signs of respiratory insufficiency, characterizing the GBS.
Using specific anti-ZIKV staining, the virus was identified in
placenta (mainly in Hofbauer cells) and in several fetal tissues,
such as brain, lungs, kidneys, skin and liver. Histological
analyses of the placenta and fetal organs revealed different
types of tissue abnormalities, which included inflammation,
hemorrhage, edema and necrosis in placenta, as well as
tissue disorganization in the fetus. Increased cellularity
(Hofbauer cells and TCD8+ lymphocytes), expression of
local pro-inflammatory cytokines such as IFN-g and TNF-α,
and other markers, such as RANTES and VEGFR2, supported
placental inflammation and dysfunction. The commitment
of the maternal-fetal link in association with fetal damage
gave rise to a discussion regarding the influence of the
maternal immunity toward the fetal development. Findings
presented in this work may help understanding the ZIKV
immunopathogenesis under the rare contexts of spontaneous
abortions in association with GBS.
e
:
marciano@ioc.fiocruz.brRare Zika case associated with Guillain-Barré Syndrome and Abortion: placental
inflammation and fetal injury
Marciano V Paes
1
, Natália G Salomao
1
, Rodrigo Basílio-de-Oliveira
2
, Jorge J Carvalho
3
and
Kíssila Rabelo
3
1
Instituto Oswaldo Cruz, Rio de Janeiro, Brazil
2
Universidade Federal do Estado do Rio de Janeiro, Rio de Janeiro, Brazil
3
Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil