Department of Physiology, All India Institute of Medical Sciences, Bhubaneswar, Odisha-751019, India.
Department of Opthalmology, All India Institute of Medical Sciences, Bhubaneswar, Odisha-751019, India.
Curr Pediatr Rev. 2024;20(3):365-369. doi: 10.2174/1573396319666230210094333.
The study aims to investigate the presence of TORCH infections in a child with bilateral cataracts and deafness and report the ToRCH-serology screening profile (Toxoplasma gondii (TOX), rubella (RV), cytomegalovirus (CMV), and herpes simplex virus (HSV-I/II)) in pediatric cataract and deafness.
Cases that had a clear clinical history of congenital cataracts and congenital deafness were included in the study. The study population consisted of 18 bilateral cataracts and 12 bilateral deafness child who was admitted to AIIMS Bhubaneswar for cataract surgery and cochlear implantation, respectively. Sera of all children were tested qualitatively and quantitatively for IgG/IgM-antibodies against ToRCH agents in a sequential manner.
Anti-IgG antibodies against the torch panel were detected in all cataract and deafness patients. Anti-CMV IgG was detected in 17 of 18 bilateral cataract children and 11 of 12 bilateral deaf children. The rates of anti-CMV IgG antibody positivity were significantly higher. In the cataract group, 94.44% and in the deafness group, 91.66% of the patient was Anti-CMV IgG positive. Besides this, 77.7 % of the patient from the cataract group and 75% from the deafness group was anti- RV IgG antibody positive. In bilateral cataract patients, IgG-alone seropositive cases were mostly attributed to CMV (94.44%; 17/18), followed by RV (77.70%; 14/18), HSV-I (27.70%; 5/18), TOX (27.70%; 5/18), and HSV-II (16.60%; 3/18). In bilateral deafness patients, the spectrum of IgG alone seropositive cases was almost the same except for TOX (0/12).
The current study recommends interpreting ToRCH-screening in pediatric cataracts and deafness with caution. Interpretation should include both serial qualitative and quantitative assays in tandem with clinical correlation to minimize diagnostic errors. The sero-clinical-positivity needs to be tested in older children who might pose a threat to the spread of infection.
本研究旨在探讨先天性白内障伴耳聋患儿是否存在 TORCH 感染，并报告儿科白内障和耳聋患者的 TORCH 血清学筛查结果（弓形虫（TOX）、风疹（RV）、巨细胞病毒（CMV）和单纯疱疹病毒 I/II（HSV-I/II））。
本研究纳入了有明确先天性白内障和先天性耳聋临床病史的病例。研究人群包括 18 例双侧白内障和 12 例双侧耳聋患儿，他们分别因白内障手术和人工耳蜗植入术入住奥里萨邦 AIIMS。所有患儿的血清均采用定性和定量方法依次检测针对 TORCH 病原体的 IgG/IgM 抗体。
所有白内障和耳聋患者均检测到针对 torch 面板的 IgG 抗体。18 例双侧白内障患儿中，17 例和 12 例双侧耳聋患儿中，11 例抗 CMV IgG 阳性。CMV IgG 抗体阳性率明显更高。在白内障组中，94.44%的患者抗 CMV IgG 阳性，在耳聋组中，91.66%的患者抗 CMV IgG 阳性。此外，白内障组 77.7%的患者和耳聋组 75%的患者抗 RV IgG 抗体阳性。在双侧白内障患儿中，IgG 阳性的病例主要归因于 CMV（94.44%；17/18），其次是 RV（77.70%；14/18）、HSV-I（27.70%；5/18）、TOX（27.70%；5/18）和 HSV-II（16.60%；3/18）。在双侧耳聋患儿中，除 TOX（0/12）外，单独 IgG 阳性病例的谱几乎相同。
本研究建议在儿科白内障和耳聋患者中谨慎解读 TORCH 筛查结果。解读应包括定性和定量的连续检测，并结合临床相关性，以最大限度地减少诊断错误。需要对可能威胁感染传播的大龄儿童进行血清学临床阳性检测。
