Systematic Reviews
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Sep 6, 2022; 10(25): 8922-8931
Published online Sep 6, 2022. doi: 10.12998/wjcc.v10.i25.8922
Lymphocytic choriomeningitis virus: An under-recognized congenital teratogen
Thomas Ferenc, Mateja Vujica, Anna Mrzljak, Tatjana Vilibic-Cavlek
Thomas Ferenc, Department of Radiology, Merkur University Hospital, Zagreb 10000, Croatia
Mateja Vujica, Department of Emergency Medicine, Institute of Emergency Medicine of Krapina-Zagorje County, Krapina 49000, Croatia
Anna Mrzljak, Department of Gastroenterology and Hepatology, University Hospital Center Zagreb, Zagreb 10000, Croatia
Anna Mrzljak, Tatjana Vilibic-Cavlek, School of Medicine, University of Zagreb, Zagreb 10000, Croatia
Tatjana Vilibic-Cavlek, Department of Virology, Croatian National Institute of Public Health, Zagreb 10000, Croatia
Author contributions: Ferenc T conceived the study, performed the literature review and data acquisition, and wrote the original draft; Vujica M reviewed the literature, performed the data acquisition, and contributed to the manuscript drafting; Mrzljak A and Vilibic-Cavlek T made contributions to the concept of the study and revised the manuscript critically; All authors approved the final version of the manuscript.
Conflict-of-interest statement: All authors declare no conflict of interest.
PRISMA 2009 Checklist statement: All authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Anna Mrzljak, FEBG, MD, PhD, Associate Professor, Department of Gastroenterology and Hepatology, University Hospital Center Zagreb, Kišpatićeva 12, Zagreb 10000, Croatia. anna.mrzljak@gmail.com
Received: April 7, 2022
Peer-review started: April 7, 2022
First decision: June 16, 2022
Revised: June 21, 2022
Accepted: July 11, 2022
Article in press: July 11, 2022
Published online: September 6, 2022
Processing time: 141 Days and 0.2 Hours
Abstract
BACKGROUND

Lymphocytic choriomeningitis virus (LCMV) is a neglected rodent-borne arenavirus associated with transplacental transmission and fetal infection.

AIM

To summarize the epidemiological, clinical, and diagnostic features of reported patients with congenital LCMV infection.

METHODS

A literature search was conducted in PubMed, Medline, Google Scholar, and ResearchGate. The keywords used were ‘congenital lymphocytic choriomeningitis virus,’ and 48 studies were included. In addition, we conducted a relevant search by Reference Citation Analysis (RCA) (https://www.referencecitationanalysis.com).

RESULTS

The results have shown 27 reports of congenital LCMV infection in 86 patients, with 52.73% of them being males. Patients presented with chorioretinitis (83.53%), hydrocephalus (54.12%), and psychomotor retardation or developmental delay (54.12%). Computed tomography and/or magnetic resonance imaging most often demonstrated ventriculomegaly (74.07%), periventricular calcifications (66.67%), and microcephaly (40%). Most mothers of congenitally infected infants were exposed to rodents during pregnancy, predominantly mice, with flu-like symptoms mainly occurring during the first two trimesters of gestation. Mortality in congenitally infected children was 16.47%. The diagnosis of congenital LCMV infection was confirmed serologically in most patients (86.67%).

CONCLUSION

LCMV is still an insufficiently recognized fetal teratogen that often leads to long-term neurologic sequelae. Clinicians need to be familiar with LCMV and its potential teratogenic effect and as well as to effectively differentiate LCMV from other TORCH (T: Toxoplasma gondii, O: Other pathogens, R: Rubella virus, C: Cytomegalovirus, H: Herpes simplex virus) pathogens.

Keywords: Lymphocytic choriomeningitis virus; Congenital infection; Epidemiology; Pregnancy; TORCH

Core Tip: Lymphocytic choriomeningitis virus (LCMV) is an under-recognized rodent-borne arenavirus associated with transplacental transmission and fetal infection. Patients often present with chorioretinitis, hydrocephalus, and neurologic sequelae. Maternal exposure to rodents during gestation is a risk factor for developing viral infection. The golden standard for diagnosis is the detection of LCMV antibodies in fetal and maternal serum samples. This mini-review systematically summarizes the epidemiological, clinical, and diagnostic features of 86 reported patients with confirmed congenital LCMV infection.