The symptoms of CRS unfold when unchecked T cell activity leads to an outpouring of pro-inflammatory cytokines into the circulation (IFN-gamma initially, then IL-6, TNF-alpha, and IL-10), resulting in a sepsis-like syndrome with fevers and potential for distributive shock characterized by hypotension, delirium, disseminated intravascular coagulation, hypoxia, and even death without treatment (48). The gene discussed is IL6; the disease is congenital rubella syndrome.