Evaluation of clinically asymptomatic high risk infants with congenital cytomegalovirus infection

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Abstract

Objective

To determine the frequency of abnormal findings on evaluation of neonates with congenital CMV infection who have a normal physical examination

Study design

Retrospective, 2-center study (1996–2017) that reviewed results of complete blood cell count and platelets, serum alanine aminotransferase (ALT) and bilirubin concentrations, eye examination, cranial ultrasonography or other neuroimaging, and brainstem evoked responses performed on neonates with congenital CMV infection and a normal physical examination

Results

Of 34 infants with congenital CMV infection and a normal physical examination, 56% (19/34) had ≥1 abnormality: 39%, elevated ALT concentration; 45%, abnormal neuroimaging (five, lenticulostriate vasculopathy; six, intraventricular hemorrhage; four, calcifications); 12%, anemia; 16%, thrombocytopenia; and 3%, chorioretinitis. Seven (21%) infants had sensorineural hearing loss, and 18 infants received antiviral therapy.

Conclusion

Some infants with congenital CMV infection and a normal physical examination had abnormalities on laboratory or neuroimaging evaluation, which in some cases prompted antiviral treatment.

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Funding

AR received grant support from “A. Griffini—J. Miglierina” Fundation—Provincia di Varese Piazza Libertà 1- 21100 Varese-Italy. The Fundation was not involved in the (1) study design, (2) the collection, analysis, and interpretation of data; (3) the writing of the report; and (4) the decision to submit the paper for publication. AR wrote the first draft of the paper. The other authors have no financial relationships relevant to this article to disclose.

Author information

AR, had full access to all study data and is responsible for the data integrity and accuracy of the data analysis. He participated in the study concept and design, acquisition of data, analysis and interpretation of data, initial and subsequent drafts of the paper, and approved the final paper as submitted. FZ, participated in the study concept and design, acquisition of data, critical revision of the paper, and approved the final paper as submitted. LE.L, participated in the study concept and design, acquisition of data, critical revision of the paper, and approved the final paper as submitted. KE.O, participated in the study design, acquisition of data, critical revision of the paper, and approved the final paper as submitted. AG.S, participated in the study concept and design, acquisition of data, critical revision of the paper, and approved the final paper as submitted. FG, had full access to all study data and is responsible for the data integrity and accuracy of the data analysis. She participated in the study concept and design, acquisition of data, analysis and interpretation of data, initial and subsequent drafts of the paper, and approved the final paper as submitted. LN.V, had full access to all study data and is responsible for the data integrity and accuracy of the data analysis. She participated in the study concept and design, acquisition of data, analysis and interpretation of data, initial and subsequent drafts of the paper, and approved the final paper as submitted. JB.C, had full access to all study data and is responsible for the data integrity and accuracy of the data analysis. He participated in the study concept and design, acquisition of data, analysis and interpretation of data, initial and subsequent drafts of the paper, and approved the final paper as submitted. SV, participated in the acquisition of data, critical revision of the paper, and approved the final paper as submitted. LP, supervised the overall study by analysis and interpretation of data, critical revision of the paper for important intellectual content, and approved the final paper as submitted. FM, supervised the overall study by analysis and interpretation of data, critical revision of the paper for important intellectual content, and approved the final paper as submitted. PJ.S, had full access to all study data and is responsible for the data integrity and accuracy of the data analysis. He supervised the overall study by developing the study concept and design, acquisition of data, analysis and interpretation of data, initial and subsequent drafts of the paper, and approved the final paper as submitted.

Correspondence to Pablo J. Sánchez.

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The study was presented in part at the 4th Congenital Cytomegalovirus Conference, San Francisco, CA, October 29–31, 2012, and at the Pediatric Academic Societies’ Annual Meeting, Vancouver, BC, May 3–6, 2014

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Ronchi, A., Zeray, F., Lee, L.E. et al. Evaluation of clinically asymptomatic high risk infants with congenital cytomegalovirus infection. J Perinatol (2019) doi:10.1038/s41372-019-0501-z

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