Is Arthrogryposis Associated with Congenital Zika Virus Infection?

Summary and Comment |
August 26, 2016

Is Arthrogryposis Associated with Congenital Zika Virus Infection?

  1. Robert S. Baltimore, MD

Clinicians in Brazil describe infants with microcephaly and signs consistent with arthrogryposis and posit a common cause: gestational infection with Zika virus.

  1. Robert S. Baltimore, MD

Congenital infection with Zika virus is causally associated with microcephaly and other anomalies in newborn infants. But it has not previously been linked to arthrogryposis, a disorder characterized by multiple congenital joint contractures.

To identify a possible correlation between Zika virus infection and arthrogryposis, investigators in Brazil conducted a retrospective case series study of seven infants with brain malformation presumably caused by congenital Zika virus infection, as well as arthrogryposis and various neurologic abnormalities.

All seven infants had unilateral or bilateral orthopedic anomalies, all had abnormalities of brain cortical development demonstrated by computed tomography or magnetic resonance imaging, six had head circumference ≥2 standard deviations smaller than average, four were small for their gestational age, all had abnormal electromyographic findings, and five had ocular abnormalities. All met criteria for congenital infection likely caused by Zika virus, two infants tested had IgM antibody to Zika virus in their spinal fluid, and none had evidence of another viral infection.


The authors assume that these infants demonstrate an association of microcephaly and arthrogryposis with Zika virus infection, although not all of the infants had an independent test demonstrating that infection occurred during gestation. Still, these results add to the evidence that Zika virus infection causes profound disorganization of the developing nervous system with many different expressions.

Editor Disclosures at Time of Publication

  • Disclosures for Robert S. Baltimore, MD at time of publication Editorial boards Infectious Diseases in Children Leadership positions in professional societies Member Committee on Rheumatic Fever, Endocarditis and Kawasaki Disease


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