Division of Pediatric Neurology, Department of Pediatrics, Faculty of Medicine, University of Health Sciences, Dr. Sami Ulus Maternity and Child Health and Diseases Training and Research Hospital, Ankara, Turkiye.
Division of Pediatric Radiology, Department of Radiology, Faculty of Medicine, University of Health Sciences, Dr. Sami Ulus Maternity and Child Health and Diseases Training and Research Hospital, Ankara, Turkiye.
Turk J Med Sci. 2024 Jan 5;54(3):529-536. doi: 10.55730/1300-0144.5819. eCollection 2024.
BACKGROUND/AIM: Cytomegalovirus (CMV) is the most common congenital viral infection. Although most children with congenital CMV (approximately 85%-90%) are asymptomatic at birth, findings such as sensorineural hearing loss, microcephaly, and neurodevelopmental retardation can be observed during the follow-up. Among the brain magnetic resonance imaging (MRI) findings of CMV are white matter abnormalities, polymicrogyria, and periventricular calcification. Since a definitive diagnosis of congenital CMV cannot be made after the neonatal period, the identification of the associated phenotype is diagnostically important, but data are limited in patients who have been retrospectively diagnosed with congenital CMV infection. The aim of this study was to evaluate the short- and long-term neurological follow-up results of congenital CMV infections in a tertiary hospital.
The neurological results of fifteen patients under the age of 18 years, who had a definitive diagnosis of congenital CMV infection and were followed up in a tertiary care hospital between 2011 and 2020, were retrospectively evaluated.
Ten of the patients in our study group were male. The mean age at presentation for neurological evaluation was 2.02 ± 1.54 months, with a median follow-up time of 36.3 months (range: 9.3-129.4 months). Neurological disorders detected during the long-term follow-up included cerebral palsy (46.7%), cognitive impairment (46.7%), epilepsy (40%), and sensorineural hearing loss (26.7%). The most common abnormality observed on MRI scans was white matter involvement (53.3%).
Early diagnosis and intervention are crucial in congenital CMV infection, as it commonly results in neurological involvement among the patients in our series. This preventable condition warrants further research regarding prenatal/neonatal screening.
背景/目的：巨细胞病毒（CMV）是最常见的先天性病毒感染。虽然大多数先天性 CMV（约 85%-90%）患儿出生时无症状，但在随访过程中可观察到感觉神经性听力损失、小头畸形和神经发育迟缓等表现。CMV 的脑磁共振成像（MRI）表现包括白质异常、多微小脑回和脑室周围钙化。由于新生儿期后无法明确诊断先天性 CMV，因此识别相关表型具有重要的诊断意义，但在回顾性诊断为先天性 CMV 感染的患者中数据有限。本研究旨在评估三级医院先天性 CMV 感染的短期和长期神经随访结果。
回顾性评估了 2011 年至 2020 年期间在三级医院确诊为先天性 CMV 感染并接受随访的 15 名年龄在 18 岁以下的患者的神经学结果。
我们研究组的 10 名患者为男性。神经评估时的平均年龄为 2.02±1.54 个月，中位随访时间为 36.3 个月（范围：9.3-129.4 个月）。长期随访中发现的神经障碍包括脑瘫（46.7%）、认知障碍（46.7%）、癫痫（40%）和感觉神经性听力损失（26.7%）。MRI 扫描最常见的异常是白质受累（53.3%）。
先天性 CMV 感染中，早期诊断和干预至关重要，因为在我们的系列患者中，它通常会导致神经受累。这种可预防的疾病需要进一步研究产前/新生儿筛查。
