Vol.12, No 3, 2005 pp. 154 - 158
UC 616.988-053.2
CYTOMEGALOVIRUS INFECTION IN INFANTS
WITH HEPATOSPLENOMEGALY
Gordana Tasić1, Dobrila
Stanković-Djordjević1, Marina
Dinić1, Hristina Stamenković2,
Milena Tasić1
1Institute for Public Health, 2Clinic
of Pediatrics, Faculty of Medicine, University of Niš, Serbia and
Montenegro
E-mail: mmtas@medfak.ni.ac.yu
Summary. Cytomegalovirus (CMV) infection is the most
common congenital infection with the incidence varying from 1% to 3%.
At birth, approximately 10% of intrauterine infected infants
demonstrate clinical symptoms and signs of infection which carries a
risk of morbidity and mortality. Perinatal infection occurs in the
contact of an infant with secretions and excretions of the mother with
active CMV infection either by passing the birth canal or by excreting
the virus into breast milk. The aim of this paper was to determine the
involvement of CMV infection in the occurrence of hepatosplenomegaly in
1-5 month-old-infants and a possible involvement of recurrent maternal
CMV infection in symptomatic congenital and perinatal infection. The
investigated group included nine 1-5 month-old-infants with
hepatosplenomegaly, hyperbilirubinemia, and increased transaminases.
None of the investigated infants had evident malformations at birth.
All hepatotropic viruses and HIV infection were excluded in all infants.
ELISA test for detection of CMV IgM and IgG antibodies was performed on
blood samples taken from mothers and their infants and antigenemia
assay for CMV pp65 antigen detection in the blood. By CMV pp65 antigen
detection in the blood, active CMV infection was established in 5 of
the total of 9 infants with the syndrome of hepatosplenomegaly referred
to the virology laboratory. One out of 5 infants was positive for anti
CMV IgM antibodies. In 2 of 5 mothers, primary CMV infection in
pregnancy was excluded. The presence of hepatosplenomegaly in 1-5 month
old infants is indicative of congenital or perinatal CMV infection.
Recurrent maternal infection can result in symptomatic, congenital or
perinatal infection.
Key words: Cytomegalovirus, hepatosplenomegaly, congenital,
perinatal, antigenemia
CITOMEGALOVIRUSNA INFEKCIJA KOD DECE
SA HEPATOSPLENOMEGALIJOM
Kratak sadržaj: Citomegalovirusna (CMV) infekcija je najčešća
kongenitalna infekcija sa incidencom 1-3%. Na rodjenju oko 10%
intrauterino inficirane dece ispoljava kliničke simptome i znake
infekcije sa rizikom po morbiditet i mortalitet. Perinatalna infekcija
dešava se u kontaktu novorodjenčeta sa sekretima i ekskretima majke
koja ima aktivnu CMV infekciju ,bilo prolaskom kroz porodjajni kanal
ili majčinim mlekom. Cilj rada bio je da se utvrdi učešće CMV infekcije
u nastanku hepatosplenomgalije kod dece starosti 1-5 meseci i
eventualno učešće rekurentne CMV infekcije majke u simptomatskoj
kongenitalnoj i perinatalnoj infekciji. Ispitivana grupa obuhvatala je
9 dece starosti do 5 meseci koja su imala hepatosplenomegaliju,
hiperbilirubinemiju i povećane transaminaze. Nijedno od ispitivane dece
nije imalo evidentirane malformacije na rodjenu. Kod sve dece bili su
isključeni svi hepatotropni virusi i HIV infekcija.
Iz uzorka krvi,uzetog od dece i njihovih majki, radjen je ELISA test za
detekciju CMV IgM i IgG antitela i test za detekciju CMV pp65 u krvi.
Od ukupno 9 dece koja su bila upućena u virusološku laboratoriju sa
sindromom hepatosplenomegalija kod 5 dece utvrdjena je aktivna CMV
infekcija detekcijom CMV pp65 antigena. Jedno od petoro dece imalo je
anti CMV IgM. Kod dve od pet majki isključena je primarna CMV infekcija
u trudnoci. Prisustvo hepatosplenomegalije kod dece do 5 meseci života
indikativno je za kongenitalnu ili perinatalnu CMV infekciju.
Rekurentna infekcija majke može da rezultira simptomatskom
kongenitalnom ili perinatalnom infekcijom.
Ključne reči: Citomegalovirus, hepatosplenomegalija,
kongenitalna, perinatalna, antigenemija