Department of Pediatric Infectious Diseases, Faculty of Medicine, Gazi University, Ankara, Turkey.
Department of Pediatric Infectious Diseases, Ankara Hematology Oncology Children's Training and Research Hospital, Ankara, Turkey.
Turk J Med Sci. 2016 Dec 20;46(6):1629-1633. doi: 10.3906/sag-1507-161.
BACKGROUND/AIM: Cytomegalovirus (CMV) hepatitis is generally asymptomatic or rarely can lead to severe complications in immunocompetent hosts. This study aims to evaluate CMV hepatitis in immunocompetent young children, which is discussed relatively rarely in the literature.
A retrospective review of 49 pediatric patients with CMV hepatitis from January 2005 to December 2010 was performed.
The median age of the patients was 5.81 ± 6.49 months and 57.1% were female. Complaints were prolonged jaundice, vomiting, diarrhea, and abdominal distension. Seventeen patients (34.6%) had congenital or probable congenital CMV infection, while 32/49 (65.3%) had perinatal CMV infection. CMV hepatitis was accompanied by other system findings in 22 patients (44.9%), and only liver involvement was present in 27/49 (55.1%). Alanine aminotransferase and aspartate aminotransferase were elevated together in all patients. Cholestatic hepatitis was present in 13 patients (26.5%). Four patients (8.16%) were treated with ganciclovir. Complete improvement of hepatitis occurred in 48/49 (97.95%). The recovery time of liver function tests was 7-180 days (mean: 53.92 ± 40.8).
CMV hepatitis is usually mild and has a good outcome in immunocompetent individuals. However, cases should be carefully evaluated due to the important role of CMV in the etiology of infantile and neonatal hepatitis.
背景/目的：巨细胞病毒（CMV）肝炎通常无症状，或在免疫功能正常的宿主中很少导致严重并发症。本研究旨在评估免疫功能正常的幼儿中的 CMV 肝炎，该主题在文献中讨论相对较少。
回顾性分析了 2005 年 1 月至 2010 年 12 月期间 49 例 CMV 肝炎患儿的资料。
患者的中位年龄为 5.81±6.49 个月，57.1%为女性。主要症状为黄疸持续时间延长、呕吐、腹泻和腹胀。17 例（34.6%）患有先天性或可能先天性 CMV 感染，而 32/49（65.3%）有围生期 CMV 感染。22 例（44.9%）CMV 肝炎伴有其他系统表现，仅 27/49（55.1%）有肝脏受累。所有患者的丙氨酸氨基转移酶和天冬氨酸氨基转移酶均升高。13 例（26.5%）为胆汁淤积性肝炎。4 例（8.16%）接受更昔洛韦治疗。49 例（97.95%）患者的肝炎完全改善。肝功能检查恢复时间为 7-180 天（平均：53.92±40.8）。
CMV 肝炎在免疫功能正常的个体中通常较轻且预后良好。然而，由于 CMV 在婴儿和新生儿肝炎的病因学中起重要作用，因此应仔细评估病例。
