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PO-0104 Different Clinical Spectrum Of Cytomegalovirus Hepatitis In Infants
  1. T Ozkan,
  2. D Altay,
  3. A Otuzbir,
  4. U Sahin,
  5. T Ozgur
  1. Pediatric Gastroenterology Hepatology and Nutrition, Uludag University Medical Faculty, Bursa, Turkey

Abstract

Background and aim Cytomegalovirus (CMV) is, a member of the herpes viridae family, found widely in nature and the most common congenital infection in newborns. The average incidence of CMV infection in newborn infants is 1%. Irreversible signs of central nervous system involvement (microcephaly, deafness, mental-motor retardation) develops in 5–10% congenitally infected infants. Signs of perinatal infections, hepatosplenomegaly, pneumonia, hepatitis, are seen, but in this period neurological sequelae are rare. In this study, CMV-infected patients who were admitted to our clinic within 3 months were examined.

Methods Between the date of December 2013 and February 2014, in total five CMV infection (min 45 days, max 2 years–4 months old) have been detected at Uludag University, Faculty of Medicine, Department of Paediatric Gastroenterology. Three of those patients admitted with jaundice and other two patients were detected during the pancytopenia aetiology and vomiting aetiology investigation.

In our series, which consist of developed CMV hepatitis cases due to different etiological reasons, retrospective examination is conducted with clinical and laboratory findings.

Results Biliary atresia was detected in three patients. One is by intraoperative cholangiography and other two, as evidenced by histopathology. In the fourth case, CMV infection was detected simultaneously with vitamin B12 deficiency during pancytopenia investigation. In the fifth patient, performed liver transplantation due to neonatal hepatitis, CMV infection was detected during investigating for vomiting and elevated aminotransferase levels in outpatient control. In one of the cases of biliary atresia with microcephaly, deafness and mental-motor retardation was considered due to congenital CMV infection. Other cases were evaluated as perinatally infection. Five patients were given ganciclovir therapy. Duration of the therapy was; six weeks for patient with congenital CMV infection and two weeks for the other four patients.

Conclusion Biliary atresia were seen in all our cases with cholestasis and there is importance of seeing it with CMV hepatitis which, in our conclusion, requires comprehensive studies. In addition, seeing these patient in such a short period of time was found interesting in epidemiological perspective.

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