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.

 

 
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