Ogawa Hiroshi, Baba Yoko, Suzutani Tatsuo, Inoue Naoki, Fukushima Eiko, Omori Koichi
Department of Otolaryngology, Fukushima Medical University, Fukushima, Japan.
Laryngoscope. 2006 Nov;116(11):1991-4. doi: 10.1097/01.mlg.0000237633.28017.62.
OBJECTIVES/HYPOTHESIS: Congenital cytomegalovirus (CMV) infection is estimated to account for 30% of sensorineural hearing loss (SNHL) cases. Differences in clinical characteristics between CMV-related and unrelated SNHL cases were scrutinized.
Using dried umbilical cord, we have recently developed a polymerase chain reaction (PCR)-based assay for the retrospective detection of congenital CMV infection. Medical records of 7 CMV-related patients identified from 31 SNHL patients by the assay were evaluated for the following: type and degree of hearing impairment, computed tomographic scan results, mental retardation, cerebral palsy, autism, and other multiple disorders.
Clinical characteristics of the seven CMV-related SNHL cases were as follows: 1) six of the seven exhibited severe bilateral SNHL, whereas one had severe unilateral SNHL in the right ear. Although the hearing levels of CMV-related patients were more greatly impaired than those of CMV-negative patients, there was no hearing impairment pattern specific to the CMV-related patients; 2) five patients had mental retardation, which was more frequent than in CMV-negative patients; 3) birth weights of the CMV-positive cases were relatively lower.
Although CMV-positive cases are clinically indistinguishable from CMV-negative cases, our PCR system allowed the retrospective diagnosis of CMV-related SNHL.
CMV-related SNHL tends to accompany mental retardation and low birth weight more frequently than does CMV-negative SNHL.
目的/假设:据估计,先天性巨细胞病毒(CMV)感染占感音神经性听力损失(SNHL)病例的30%。对CMV相关和非相关SNHL病例的临床特征差异进行了仔细研究。
我们最近利用干燥脐带开发了一种基于聚合酶链反应(PCR)的检测方法,用于回顾性检测先天性CMV感染。对通过该检测方法从31例SNHL患者中确定的7例CMV相关患者的病历进行了以下评估:听力障碍的类型和程度、计算机断层扫描结果、智力迟钝、脑瘫、自闭症和其他多种疾病。
7例CMV相关SNHL病例的临床特征如下:1)7例中有6例表现为严重双侧SNHL,而1例右耳有严重单侧SNHL。虽然CMV相关患者的听力水平比CMV阴性患者受损更严重,但CMV相关患者没有特定的听力障碍模式;2)5例患者有智力迟钝,比CMV阴性患者更常见;3)CMV阳性病例的出生体重相对较低。
虽然CMV阳性病例在临床上与CMV阴性病例无法区分,但我们的PCR系统允许对CMV相关SNHL进行回顾性诊断。
与CMV阴性SNHL相比,CMV相关SNHL更常伴有智力迟钝和低出生体重。