Department of Tropical Medicine, Health Sciences Center, Federal University of Pernambuco, Recife 50670-901, Brazil.
Unit Endocrinology, Oswaldo Cruz University Hospital, Recife 50100-130, Brazil.
Viruses. 2020 Dec 22;13(1):1. doi: 10.3390/v13010001.
Congenital viral infections and the occurrence of septo-optic dysplasia, which is a combination of optic nerve hypoplasia, abnormal formation of structures along the midline of the brain, and pituitary hypofunction, support the biological plausibility of endocrine dysfunction in Zika-related microcephaly. In this case series we ascertained the presence and describe endocrine dysfunction in 30 children with severe Zika-related microcephaly from the MERG Pediatric Cohort, referred for endocrinological evaluation between February and August 2019. Of the 30 children, 97% had severe microcephaly. The average age at the endocrinological consultation was 41 months and 53% were female. The most frequently observed endocrine dysfunctions comprised short stature, hypothyroidism, obesity and variants early puberty. These dysfunctions occurred alone 57% or in combination 43%. We found optic nerve hypoplasia (6/21) and corpus callosum hypoplasia (20/21). Seizure crises were reported in 86% of the children. The most common-and clinically important-endocrine dysfunctions were pubertal dysfunctions, thyroid disease, growth impairment, and obesity. These dysfunctions require careful monitoring and signal the need for endocrinological evaluation in children with Zika-related microcephaly, in order to make early diagnoses and implement appropriate treatment when necessary.
先天性病毒感染和发生的视-隔发育不良，这是视神经发育不良、脑中线结构异常形成和垂体功能低下的组合，支持寨卡病毒相关小头畸形中内分泌功能障碍的生物学合理性。在本病例系列中，我们确定了存在并描述了 30 名严重寨卡病毒相关小头畸形儿童的内分泌功能障碍，这些儿童来自 MERG 儿科队列，于 2019 年 2 月至 8 月期间因内分泌评估而转诊。在这 30 名儿童中，97%患有严重小头畸形。内分泌会诊的平均年龄为 41 个月，53%为女性。最常观察到的内分泌功能障碍包括身材矮小、甲状腺功能减退症、肥胖和早期青春期变异。这些功能障碍单独发生的比例为 57%，联合发生的比例为 43%。我们发现视神经发育不良（6/21）和胼胝体发育不良（20/21）。86%的儿童报告有癫痫发作危机。最常见和临床上重要的内分泌功能障碍是青春期功能障碍、甲状腺疾病、生长障碍和肥胖。这些功能障碍需要仔细监测，并提示寨卡病毒相关小头畸形儿童需要进行内分泌评估，以便及早诊断并在必要时实施适当的治疗。
