Gowda Vykuntaraju K, Kulhalli Preeti, Vamyanmane Dhananjaya K
Department of Pediatric Neurology, Indira Gandhi Institute of Child health, Bengaluru, Karnataka, India.
Department of Pediatrics, Karnataka Institute of Medical Sciences, Hubballi, Karnataka, India.
J Neurosci Rural Pract. 2021 Jan;12(1):133-136. doi: 10.1055/s-0040-1721557. Epub 2021 Jan 29.
Cytomegalovirus (CMV) is a ubiquitous herpes virus. It is the most common congenital viral infection. Data on congenital CMV in India are lacking and hence the present study was undertaken. The aim of the study is to evaluate the clinical and radiological profile of neurological manifestations of congenital CMV infections in tertiary care hospital. This is a retrospective chart review of the clinical and laboratory profile of congenital CMV infections presenting from January 2018 to February 2020 to a tertiary care hospital in Southern India. Details of clinical profile, serological and neuroimaging data were obtained and analyzed. A total of 42 cases with female preponderance (57%) were reported during the study period. The mean age of presentation was 2.9 years. Clinical features were developmental delay (81%), microcephaly (93%), seizures (33%), intrauterine growth restriction (19%), neonatal encephalopathy (10%), anemia (9%), jaundice (10%), hepato-splenomegaly (7%), and eye abnormalities (14%). Antenatal maternal fever was reported by 12%. Sensorineural hearing loss was present in 57%. Neuroimaging showed periventricular calcification (79%), cerebral atrophy (69%), ventricular dilatation (55%), malformations (26%), dysmyelination (12%), and temporal lobe cysts (5%). CMV-immunoglobulin-M positivity was seen in 14 cases (33%), urinary polymerase chain reaction for CMV was positive in 21 cases (50%), and clinical diagnosis was done in seven cases (16%). Common findings in congenital CMV are microcephaly, developmental delay, seizures, anemia, and sensorineural hearing loss. Common neuroimaging findings are periventricular calcification, cerebral atrophy, malformation, white matter signal changes, and cysts. CMV can mimic like cerebral palsy, malformations of the brain, demyelinating disorders, and calcified leukoencephalopathies like Aicardi-Goutières syndrome.
巨细胞病毒（CMV）是一种普遍存在的疱疹病毒。它是最常见的先天性病毒感染。印度缺乏关于先天性CMV的资料，因此开展了本研究。
本研究的目的是评估三级护理医院中先天性CMV感染的神经学表现的临床和影像学特征。
这是一项对2018年1月至2020年2月期间就诊于印度南部一家三级护理医院的先天性CMV感染的临床和实验室资料进行的回顾性图表审查。获取并分析了临床资料、血清学和神经影像学数据的详细信息。
研究期间共报告了42例病例，女性占多数（57%）。平均就诊年龄为2.9岁。临床特征包括发育迟缓（81%）、小头畸形（93%）、癫痫发作（33%）、宫内生长受限（19%）、新生儿脑病（10%）、贫血（9%）、黄疸（10%）、肝脾肿大（7%）和眼部异常（14%）。12%的病例报告有产前母亲发热。57%的病例存在感音神经性听力损失。神经影像学显示脑室周围钙化（79%）、脑萎缩（69%）、脑室扩张（55%）、畸形（26%）、脱髓鞘（12%）和颞叶囊肿（5%）。14例（33%）CMV免疫球蛋白M呈阳性，21例（50%）CMV尿聚合酶链反应呈阳性，7例（16%）为临床诊断。
先天性CMV的常见表现为小头畸形、发育迟缓、癫痫发作、贫血和感音神经性听力损失。常见的神经影像学表现为脑室周围钙化、脑萎缩、畸形、白质信号改变和囊肿。CMV可类似脑性瘫痪、脑畸形、脱髓鞘疾病以及像Aicardi-Goutières综合征那样的钙化性白质脑病。
