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Gurzu S, Burlacu D, Sánta R, Jung I, Slevin M, Fulop E. Case Report: Coexistence of generalized arterial calcification of infancy (GACI) and maternal infections with cytomegalovirus and Toxoplasma gondii-unexpected fatal complication in a newborn. Front Pediatr 2022; 10:922379. [PMID: 36061401 PMCID: PMC9434010 DOI: 10.3389/fped.2022.922379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2022] [Accepted: 06/15/2022] [Indexed: 11/13/2022] Open
Abstract
Generalized arterial calcification of infancy (GACI) is an extremely rare autosomal recessive condition characterized by the storage of calcium at the level of internal elastic membrane of arteries. The main consequences are intimal fibrous thickening and arterial occlusion. We present the case of a preterm male infant, born from an improperly dispensed pregnancy. At birth, the newborn presented generalized edema and hypotonia, and abolished heart sounds, without response to stimulation. Despite the mechanical ventilation, the infant died 2 h after birth. The death was clinically presumed to be related to the maternal infection with cytomegalovirus (CMV) and Toxoplasma gondii. The infant's mother affirmed the history of 6 previous miscarriages and a non-consanguineous marriage. At autopsy, microscopic examination showed generalized vasculitis secondary to minimal calcification of the large and medium-sized vessels of the lungs, liver, and tongue. These findings supported the diagnosis of GACI. Hydrothorax, non-infective ascites, and necrosis of the brain parenchyma were also associated. The premature infant died due to tonsillar herniation associated with decreased vessel compliance and refractory pulmonary hypertension thus leading to congestive cardiac failure. CMV was not detected on histopathological assessment nor were signs of any other infections. To the best of our knowledge, this is the first case of GACI occurring in a baby from a mother co-infected with CMV and T. gondii.
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Affiliation(s)
- Simona Gurzu
- Department of Pathology, George Emil Palade University of Medicine, Pharmacy, Science and Technology, Târgu Mureş, Romania.,Department of Pathology, Clinical County Emergency Hospital, Târgu Mureş, Romania.,Research Center in Oncology and Translational Medicine (CCOMT), University of Medicine, Pharmacy, Science and Technology, Târgu Mureş, Romania
| | - Diana Burlacu
- Department of Pathology, George Emil Palade University of Medicine, Pharmacy, Science and Technology, Târgu Mureş, Romania.,Department of Pathology, Clinical County Emergency Hospital, Târgu Mureş, Romania
| | - Réka Sánta
- Department of Pediatrics and Neonatology, Clinical County Emergency Hospital, Târgu Mureş, Romania.,Department of Pediatrics, George Emil Palade University of Medicine, Pharmacy, Science and Technology, Târgu Mureş, Romania
| | - Ioan Jung
- Department of Pathology, George Emil Palade University of Medicine, Pharmacy, Science and Technology, Târgu Mureş, Romania
| | - Mark Slevin
- Doctoral School, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Târgu Mures, Târgu Mures, Romania
| | - Emöke Fulop
- Department of Pathology, Clinical County Emergency Hospital, Târgu Mureş, Romania
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Foldvari F, Vertes B, Fulop E. [New data on the pathogenic mechanism of cutaneous hemorrhages produced during steroid treatment]. G Ital Dermatol Minerva Dermatol 1966; 107:691-9. [PMID: 5300592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
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