Reiterer F, Dornbusch H J, Urlesberger B, Reittner P, Fotter R, Zach M, Popper H, Müller W
Dept of Pediatrics, University of Graz, Austria.
Eur Respir J. 1999 Feb;13(2):460-2. doi: 10.1183/09031936.99.13246099.
Lung injury caused by intrauterine inflammation has recently been strongly implicated in the pathogenesis of Wilson-Mikity syndrome (WMS). This article supports this theory by suggesting a causative role of intrauterine cytomegalovirus (CMV) infection for the development of WMS. A male premature infant, born at 33 weeks of gestational age, developed chronic lung disease compatible with WMS and diagnostic evaluation was positive for CMV infection. High-resolution computed tomography scan and lung histology revealed typical features of WMS in association with signs of interstitial pneumonia. CMV was found in urine, breastmilk, bronchoalveolar lavage material and lung tissue from open lung biopsy. Follow-up after treatment with ganciclovir and steroids showed resolving lung disease at the age of 6, 10 and 16 months, with lung function signs of mild obstruction. Assuming that a chance coexistence of cytomegalovirus pneumonia and Wilson-Mikity syndrome is rather unlikely, it is possible that intrauterine cytomegalovirus infection caused a pattern of lung injury consistent with Wilson-Mikity syndrome. Further cases of Wilson-Mikity syndrome should be investigated as to a possible role of congenital infection.
宫内炎症所致的肺损伤最近被强烈认为与威尔逊-米基蒂综合征（WMS）的发病机制有关。本文通过提示宫内巨细胞病毒（CMV）感染在WMS发生中的致病作用来支持这一理论。一名孕33周出生的男性早产儿患与WMS相符的慢性肺病，诊断评估CMV感染呈阳性。高分辨率计算机断层扫描和肺组织学检查显示WMS的典型特征以及间质性肺炎的征象。在尿液、母乳、支气管肺泡灌洗材料和开胸肺活检的肺组织中发现了CMV。用更昔洛韦和类固醇治疗后的随访显示，在6个月、10个月和16个月时肺病有所缓解，有轻度阻塞的肺功能征象。假设巨细胞病毒肺炎与威尔逊-米基蒂综合征偶然并存的可能性很小，那么宫内巨细胞病毒感染有可能导致了与威尔逊-米基蒂综合征相符的肺损伤模式。对于威尔逊-米基蒂综合征的更多病例，应调查先天性感染可能发挥的作用。
