Kobayashi Yoko, Morioka Ichiro, Koda Tsubasa, Nakamachi Yuji, Okazaki Yoko, Noguchi Yoriko, Ogi Miki, Chikahira Masatsugu, Tanimura Kenji, Ebina Yasuhiko, Funakoshi Toru, Ohashi Masanobu, Iijima Kazumoto, Inoue Naoki, Kawano Seiji, Yamada Hideto
J Perinat Med. 2015 Mar;43(2):239-43. doi: 10.1515/jpm-2014-0071.
Neurological outcomes differ considerably between symptomatic and asymptomatic infants with congenital cytomegalovirus (CMV) infection. Our objective was to characterize laboratory markers in symptomatic newborns in comparison with asymptomatic newborns with congenital CMV infection.
Ten newborns with symptomatic and 13 newborns with asymptomatic congenital CMV infection were included in this 3-year prospective cohort study. Total immunoglobulin M (IgM), CMV-IgM, CMV antigenemia, and CMV-DNA in blood and urine were measured and their positive rates and quantitative values compared between the symptomatic and asymptomatic groups.
Fifty percent of newborns in the symptomatic group were positive based on total IgM; this was significantly lower than in the asymptomatic group (100%). Quantitative total IgM values were significantly lower, and there were significantly more copies of CMV-DNA in the blood of symptomatic newborns than in asymptomatic newborns (median values for total IgM: 14 vs. 43 mg/dL and blood CMV-DNA: 3.2×102 vs. 3.5×101 copies/106 white blood cells). CMV-IgM, CMV antigenemia, and urine CMV-DNA did not differ significantly between groups.
Low total IgM values and high blood CMV loads were associated with the presence of symptoms in newborns with congenital CMV infection.
先天性巨细胞病毒（CMV）感染的有症状和无症状婴儿的神经学结局有很大差异。我们的目标是与先天性CMV感染的无症状新生儿相比，对有症状新生儿的实验室指标进行特征描述。
这项为期3年的前瞻性队列研究纳入了10例有症状的新生儿和13例无症状先天性CMV感染的新生儿。测量血液和尿液中的总免疫球蛋白M（IgM）、CMV-IgM、CMV抗原血症和CMV-DNA，并比较有症状组和无症状组之间它们的阳性率和定量值。
基于总IgM，有症状组50%的新生儿呈阳性；这显著低于无症状组（100%）。有症状新生儿血液中总IgM的定量值显著更低，且CMV-DNA的拷贝数显著多于无症状新生儿（总IgM的中位数：14 vs. 43 mg/dL，血液CMV-DNA：3.2×10² vs. 3.5×10¹拷贝/10⁶白细胞）。CMV-IgM、CMV抗原血症和尿液CMV-DNA在两组之间无显著差异。
总IgM值低和血液CMV载量高与先天性CMV感染新生儿的症状存在相关。
