To understand a mechanism for the difference in clinical manifestations of congenital
cytomegalovirus (CMV) infection between dizygotic twins, the placentas of the dizygotic
twins were evaluated for the number of the cells infected with CMV by immunohistochemical
and in situ hybridization studies. A Japanese woman with dizygotic twin pregnancy
had immunoglobulin M antibodies to CMV at 15 weeks gestation. Intrauterine growth
retardation was noted only in the first twin. At birth, CMV was isolated from urine
culture in both twins. Clinical manifestations for CMV, such as petechiae, jaundice,
hepatosplenomegaly, and deafness were more pronounced in the first twin than in the
second twin. Immunohistochemical and in situ hybridization studies showed CMV-positive
cells two or three times more densely distributed in the placenta of the first twin
compared with the second twin. These data suggest the severity of CMV manifestations
of dizygotic twins may be in accord with the number of CMV-positive cells in the placenta.
KEYWORDS
Cytomegalovirus - congenital infection - dizygotic twins - placenta
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Kei KawanaM.D. Ph.D.
Department of Obstetrics and Gynecology, Faculty of Medicine, University of Tokyo
7-3-1 Hongo, Bunkyo-ku, 113-8655 Tokyo, Japan