A Case of Congenital Rubella Syndrome.

Jeong, Jin Ho; Lee, Hye Jin; Lee, Sun Ho; Kim, Sung Gon

doi:2013.54.7.1119

J Korean Ophthalmol Soc > Volume 54(7); 2013 > Article

Case Report

Journal of the Korean Ophthalmological Society 2013;54(7):1119-1125.
DOI: https://doi.org/10.3341/jkos.2013.54.7.1119 Published online July 15, 2013.

A Case of Congenital Rubella Syndrome.

Jin Ho Jeong, Hye Jin Lee, Sun Ho Lee, Sung Gon Kim

Department of Ophthalmology, Jeju National University School of Medicine, Jeju, Korea. amario@naver.com

선천성 풍진 증후군 1 예

정진호⋅이혜진⋅이선호⋅김성곤

Department of Ophthalmology, Jeju National University School of Medicine, Jeju, Korea

Abstract

PURPOSE
We report a case of congenital rubella syndrome with bilateral zonular cataracts. CASE SUMMARY: A 69-year-old man visited the hospital with visual disturbance in both eyes. His mother had been diagnosed with rubella during pregnancy, exhibiting typical fever and rashes. His visual acuity and hearing ability had been poor since birth. Corrected visual acuity was 0.3 in the right eye and 0.4 in the left eye. Slit lamp examination revealed bilateral zonular cataracts. On pure tone audiometry test, pure tone hearing threshold was 73 dB in the right ear and 72 dB in the left ear, corresponding to severe hearing loss in both ears. Echocardiogram showed a 1.5 cm-sized ostium secundum atrial septal defect, causing atrial fibrillation. Laboratory workup revealed an extremely high level of IgG antibody (titer = 1:301), and negative IgM antibody. A rubella IgG avidity test was 95.5%, suggesting remote rubella infection. Chromosomal analysis from peripheral blood did not show any abnormalities. The patient was diagnosed with congenital rubella syndrome with bilateral zonular cataracts. Two months after cataract surgery on both eyes, visual acuity steadily improved to 1.0 in both eyes. CONCLUSIONS: Congenital rubella syndrome is comprised of physical abnormalities such as sensorineural hearing loss, eye defects including congenital cataract, and cardiovascular defects due to gestational rubella infection. The possibility of congenital rubella syndrome should be considered even in old age, and a systemic multi-organ approach is necessary for therapeutic planning.

Key Words: Congenital rubella syndrome;Gestational rubella infection;Zonular cataract