CYTOMEGALOVIRUS ASSOCIATED HEPATITIS IN INFANTS
Georgieva每Shakola
M1, Valtcheva E1, Tzaneva V1,
Popova M1, Pavlova D1, Manevska B2,
Krasnaliev I2
1 University Hospital &St.
Marina*, Department of Pediatrics, Varna, Bulgaria
2 Medical University,
Department of Pathology, Varna, Bulgaria
Objective: Congenital
cytomegalovirus (CMV) infections are asymptomatic in the neonatal period.
CMV - associated hepatitis in infants are shown with direct and indirect
reaching hyperbilirubinemia, mild elevation of the liver enzymes or
anicretic forms. The study*s aim was to reveal five patients, from 40 days
to 12 months old, with clinical manifestations of CMV - associated
hepatitis.
Methods: The retrospective study
was designed to show in a period of 1998 每 2000 among 364 infants, children
and adolescents with chronic liver disease. 172 of them were infants and 5
/ 172 patients (pts) were with CMV 每 associated hepatitis. All pts have
been consulting and hospitalizing in University Hospital 每 Varna.
Results: The common
manifestation of CMV infection rate in different characteristics: 5 cases
include hepatomegaly, splenomegaly, elevation of the liver enzymes; 3/5 pts
were with progressive cholestasis; 2/5 pts were with icterus; 2/5 pts with
ascites; 2/5 pts were with microphtalmia; 1/5 pts was with maculopapular
rash and cyanosis; 1/5 pts was with club foot deformities. CMV infections
in these patients was diagnosed by serologic tests and quantitive IgM
levels in infants and mothers. Ganciclovir therapy was given intravenously
to two infants in regimen 3 mg/kg/twice daily for 21 days, with clinical
success in one of them. 3/5 pts died of acute liver failure of the age of
8, 10 and 12 months respectively. In both patients were found to have
characteristic pathologic features of CMV infection and giant cell
hepatitis.
Conclusion: A variety of CMV
infections are responsible for a large proportion of the morbidity, both in
the diagnosis and prevention of mother 每 to 每 child transmission have
included three main aspects: epidemiologic observations, clinical and
laboratory information about mother and infant, screening tests in the
newborn.