Editing Congenital rubella syndrome (section)

==Signs and symptoms==
[[File:Infant with skin lesions from congenital rubella.jpg|thumb|Infant with skin lesions from congenital rubella]]
[[Image:Congenital Rubella Syndrome, Salt and Pepper Retinopathy.jpg|right|thumb|"Salt-and-pepper" retinopathy is characteristic of congenital rubella.<ref name=Sudharshan>{{cite journal|vauthors=Sudharshan S, Ganesh SK, Biswas J |title=Current approach in the diagnosis and management of posterior uveitis|journal=Indian J Ophthalmol|date=2010|volume=58|issue=1|pages=29–43|pmid=20029144|issn=0301-4738|doi=10.4103/0301-4738.58470|pmc=2841371 |doi-access=free }}</ref><ref>{{cite journal |last1=Khurana |first1=Rahul N. |last2=Sadda |first2=Srinivas R. |title=Salt-and-Pepper Retinopathy of Rubella |journal=[[N Engl J Med]] |date=3 Aug 2006 |volume=355 |issue=5 |page=499 |doi=10.1056/NEJMicm040780 |pmid=16885553 |url=https://www.nejm.org/doi/full/10.1056/NEJMicm040780}}</ref>]]

The classic triad for congenital rubella syndrome is:<ref>{{Cite web|title = Congenital rubella syndrome {{!}} Sense|url = http://www.sense.org.uk/content/congenital-rubella-syndrome|website = www.sense.org.uk|access-date = 2015-07-30}}</ref>
* [[Sensorineural hearing loss|Sensorineural deafness]]<ref name=":52">{{Cite book |last1=Zimmerman |first1=LA |title=Harrison's Principles of Internal Medicine |last2=Reef |first2=SE |publisher=McGraw-Hill Education |year=2022 |editor-last=Loscalzo |editor-first=Joseph |edition=21st |publication-date=2022 |chapter=Rubella (German Measles) |editor-last2=Fauci |editor-first2=A |editor-last3=Kasper |editor-first3=D |editor-last4=Hauser |editor-first4=S |editor-last5=Longo |editor-first5=D |editor-last6=Jameson |editor-first6=J}}</ref> (58% of patients)<ref name=":13">{{Cite web |year=2024 |title=Pregnancy and Rubella |url=https://www.cdc.gov/rubella/pregnancy.html |access-date=January 28, 2024 |website=Centers for Disease Control and Prevention |publication-place=Atlanta, Georgia}}</ref>
* Eye abnormalities—especially [[retinopathy]],<ref name=":52" /><ref name=":32">{{Cite journal |last1=Winter |first1=Amy K. |last2=Moss |first2=William J. |date=2022-04-02 |title=Rubella |url=https://pubmed.ncbi.nlm.nih.gov/35367004 |journal=Lancet |volume=399 |issue=10332 |pages=1336–1346 |doi=10.1016/S0140-6736(21)02691-X |issn=1474-547X |pmid=35367004|s2cid=247846943 }}</ref> [[cataract]],<ref name=":13" /><ref name=":32" /> [[glaucoma]],<ref name=":32" /> and [[microphthalmia]]<ref>{{Cite journal |last=Duszak |first=Robert S. |date=January 2009 |title=Congenital rubella syndrome--major review |url=https://pubmed.ncbi.nlm.nih.gov/19111256 |journal=Optometry (St. Louis, Mo.) |volume=80 |issue=1 |pages=36–43 |doi=10.1016/j.optm.2008.03.006 |issn=1558-1527 |pmid=19111256}}</ref> (43% of patients)<ref>{{Cite journal |last=Kumar Panda |first=Prateek |date=2019 |title=Diabetic ketoacidosis in a child with congenital rubella syndrome: A case report and review of literature |url=https://pubmed.ncbi.nlm.nih.gov/31405663 |journal=Diabetes & Metabolic Syndrome |volume=13 |issue=4 |pages=2473–2475 |doi=10.1016/j.dsx.2019.06.026 |issn=1878-0334 |pmid=31405663|s2cid=198296894 }}</ref>
* [[Congenital heart disease]]<ref name=":22">{{Citation |last1=Shukla |first1=Samarth |title=Congenital Rubella |date=2024 |work=StatPearls |url=http://www.ncbi.nlm.nih.gov/books/NBK507879/ |access-date=2024-01-28 |place=Treasure Island (FL) |publisher=StatPearls Publishing |pmid=29939656 |last2=Maraqa |first2=Nizar F.}}</ref>—especially [[Stenosis of pulmonary artery|pulmonary artery stenosis]] and [[patent ductus arteriosus]] (50% of patients)<ref>{{Cite journal|title = An update on cardiovascular malformations in congenital rubella syndrome.|date = January 2010|pmid = 19697432|journal = Birth Defects Research Part A: Clinical and Molecular Teratology|doi=10.1002/bdra.20621|volume=88|issue=1|vauthors=Oster ME, Riehle-Colarusso T, Correa A |pages=1–8|url = https://zenodo.org/record/1229131}}</ref>

Other manifestations of CRS may include:
* [[Spleen]],<ref name=":52" /><ref name=":32" /> [[liver]], or [[bone marrow]] problems (some of which may disappear shortly after birth)
* [[Intellectual disability]]<ref>{{Cite journal |last1=Das |first1=Pratyush Kumar |last2=Kielian |first2=Margaret |date=2021-04-26 |title=Molecular and Structural Insights into the Life Cycle of Rubella Virus |journal=Journal of Virology |volume=95 |issue=10 |pages=e02349–20, JVI.02349–20 |doi=10.1128/JVI.02349-20 |issn=1098-5514 |pmc=8139664 |pmid=33627388}}</ref>
* Small head size ([[microcephaly]])<ref name=":32" />
* Low birth weight<ref name=":0">{{Cite web|url=http://www.childrenshospital.org/conditions-and-treatments/conditions/c/congenital-rubella/symptoms-and-causes|title=Congenital Rubella Symptoms & Causes {{!}} Boston Children's Hospital|website=www.childrenshospital.org|access-date=2019-03-05}}</ref>
* [[Thrombocytopenic purpura]],<ref name=":52" /><ref name=":1">{{Cite journal |last1=Mawson |first1=Anthony R. |last2=Croft |first2=Ashley M. |date=2019-09-22 |title=Rubella Virus Infection, the Congenital Rubella Syndrome, and the Link to Autism |journal=International Journal of Environmental Research and Public Health |volume=16 |issue=19 |pages=3543 |doi=10.3390/ijerph16193543 |doi-access=free |issn=1660-4601 |pmc=6801530 |pmid=31546693}}</ref> leading to easy or excessive bleeding or bruising
* Extramedullary hematopoiesis (presents as a characteristic [[Blueberry muffin baby|blueberry muffin rash]])<ref name=Jong2022/>
* Enlarged liver ([[hepatomegaly]])<ref name=":5" />
* Small jaw size ([[Micrognathism|micrognathia]])<ref name=":1" />
* Radiolucent bone disease<ref name=":32" />
* Skin lesions <ref name=":0" />

Children who have been exposed to rubella in the womb should also be watched closely as they age for any indication of:
* [[Developmental disability|Developmental delay]]<ref name=":0" />
* [[Autism spectrum|Autism]]<ref name=":22" /><ref name=":1" /><ref name="pmid15121991">{{cite journal|last=Muhle|first=R |author2=Trentacoste, SV |author3=Rapin, I |author3-link=Isabelle Rapin|title=The genetics of autism.|journal=Pediatrics|date=May 2004|volume=113|issue=5|pages=e472–86|pmid=15121991|url=http://pediatrics.aappublications.org/content/113/5/e472.full|doi=10.1542/peds.113.5.e472|s2cid=6077170 |doi-access=}}</ref>
* [[Schizophrenia]]<ref name="pmid16469941">{{cite journal|last=Brown|first=A. S|title=Prenatal Infection as a Risk Factor for Schizophrenia|journal=Schizophrenia Bulletin|date=9 February 2006|volume=32|issue=2|pages=200–202|doi=10.1093/schbul/sbj052|pmid=16469941|pmc=2632220}}</ref>
* [[Growth retardation]]<ref>{{Cite journal|title = Pathogenesis of congenital rubella|journal = JAMA|date = 1965-12-20|issn = 0098-7484|pages = 1277–1283|volume = 194|issue = 12|doi = 10.1001/jama.1965.03090250011002|last1 = Naeye|first1 = Richard L.|pmid = 5898080}}</ref>
* [[Learning disability|Learning disabilities]]<ref name=":1" />
* [[Thyroid disorders]]<ref name=":1" /><ref name=":4">{{Cite journal |last1=Terracciano |first1=E |last2=Amadori |first2=F |last3=Pettinicchio |first3=V |last4=Zaratti |first4=L |last5=Franco |first5=E |date=2020-04-02 |title=Strategies for elimination of rubella in pregnancy and of congenital rubella syndrome in high and upper-middle income countries |journal=J Prev Med Hyg |volume=61 |issue=1 |pages=E98–E108 |doi= |issn= |pmc=7225652 |pmid=32490275 |doi-access=}}</ref>
* [[Diabetes mellitus]]<ref name=":4" /><ref>{{Cite journal|doi = 10.1016/S0140-6736(71)90057-2|pmid = 4105044|title = High Frequency of Diabetes Mellitus in Young Adults with Congenital Rubella|journal = The Lancet|volume = 298|issue = 7720|pages = 332–334|date = 1971-08-14|last1 = Forrest|first1 = Jill M.|last2 = Menser|first2 = Margaret A.|last3 = Burgess|first3 = J. A.}}</ref>