High maternal fever during gestation and severe congenital limb disruptions

Hyperthermia is defined as a temperature of at least 1.5 degreesC over the normal core body temperature. It is a proven teratogen in animals and in hu mans. The type of defects induced by hyperthermia in experimental animals a re: anencephaly/exencephaly, encephalocele, microphthalmia, arthrogryposis, abdominal wall defects, limb deficiencies, embryonic death, and resorption . In humans it has been observed that infants prenatally exposed to hyperth ermia presented with spins bifida, encephalocele, microphthalmia, micrognat hia, external ear anomalies, cardiac defects, hypospadias, gastrointestinal defects, cleft lip and/or cleft palate, abdominal wall defects, diaphragma tic hernia, Hirschsprung disease, Mobius syndrome, oromandibular-limb hypog enesis spectrum, and spontaneous abortions. We describe an additional case with severe limb deficiencies whose mother had fever over 39 degreesC for 2 days in the second and in the fourth month of amenorrhoea. We conclude tha t, based on the degree of development of the humeri and the femora and the type of limb deficiencies, this case presents a disruption that most probab ly occurred in the fourth month of gestation. (C) 2001 Wiley-Liss, Inc.