Giannattasio Antonietta, Di Costanzo Pasquale, Milite Paola, De Martino Daniela, Capone Eleonora, Romano Antonia, Bravaccio Carmela, Capasso Letizia, Raimondi Francesco
Department of Translational Medical Sciences-Section of Neonatology, University Federico II, Naples, Italy.
Department of Translational Medical Sciences-Section of Neonatology, University Federico II, Naples, Italy.
J Clin Virol. 2017 Jun;91:31-35. doi: 10.1016/j.jcv.2017.04.006. Epub 2017 Apr 6.
Lenticulostriated vasculopathy (LSV) detected in head ultrasound (HUS) has been related to neurological and hearing sequelae in infants with congenital cytomegalovirus (cCMV) infection.
To assess the role of LSV in predicting neurodevelopmental and hearing outcomes in infants with cCMV infection.
We enrolled consecutive infants who were affected by cCMV infection and underwent HUS within the first month of life. Data on clinical onset and course, laboratory findings, visual/hearing functions and neurodevelopmental outcome were collected. As controls, infants with suspected intrauterine exposure to Toxoplasma and with no confirmed congenital toxoplasmosis were considered.
Data from 161 infants with cCMV infection (105 symptomatic) and 133 controls were analyzed. HUS was normal in 66 (41%) cCMV patients. Among these, 28 (42.4%) were symptomatic and 38 (57.6%) asymptomatic infants. The percentage of patients with no HUS abnormalities was higher in asymptomatic (38/56, 67.9%) than in symptomatic infants (28/105, 26.7%) (p<0.05). LSV, as isolated or associated with other brain abnormalities, was diagnosed in 64/161 (39.7%) patients with cCMV compared to 24/133 (18%) controls (p<0.05). In cCMV group, LSV was found in 51 (48.6%) symptomatic infants and in 13 (72.2%) asymptomatic patients (p>0.05). Overall, in the whole population of 95 patients with cCMV and abnormal HUS results, LSV (alone or with other findings) did not represent a risk factor for unfavorable neurological and hearing outcome. Similar results were obtained when we limited the analysis to the group of symptomatic cCMV patients.
Although LSV is a common HUS finding in infants with cCMV infection, its presence is not predictive of an adverse outcome. Our data suggest that HUS as a single neuroimaging investigation is unreliable in selecting candidates to antiviral therapy, mainly in presence of LSV as isolated finding.
头部超声（HUS）检测到的豆纹状血管病变（LSV）与先天性巨细胞病毒（cCMV）感染婴儿的神经和听力后遗症有关。
评估LSV在预测cCMV感染婴儿神经发育和听力结局中的作用。
我们纳入了连续的cCMV感染婴儿，这些婴儿在出生后第一个月内接受了HUS检查。收集了关于临床发病和病程、实验室检查结果、视觉/听力功能及神经发育结局的数据。作为对照，考虑了疑似宫内暴露于弓形虫且未确诊先天性弓形虫病的婴儿。
分析了161例cCMV感染婴儿（105例有症状）和133例对照的数据。66例（41%）cCMV患者的HUS正常。其中，28例（42.4%）为有症状婴儿，38例（57.6%）为无症状婴儿。无症状婴儿中HUS无异常的患者比例（38/56，67.9%）高于有症状婴儿（28/105，26.7%）（p<0.05）。与24/133例（18%）对照相比，64/161例（39.7%）cCMV患者诊断出LSV，其可为孤立性病变或与其他脑异常相关（p<0.05）。在cCMV组中，51例（48.6%）有症状婴儿和13例（72.2%）无症状患者发现有LSV（p>0.05）。总体而言，在95例HUS结果异常的cCMV患者中，LSV（单独或合并其他发现）并不代表神经和听力不良结局的危险因素。当我们将分析局限于有症状的cCMV患者组时，也得到了类似结果。
虽然LSV是cCMV感染婴儿中常见的HUS表现，但其存在并不能预测不良结局。我们的数据表明，HUS作为单一的神经影像学检查，在选择抗病毒治疗的候选者时不可靠，主要是在LSV为孤立性发现的情况下。
