Asymptomatic congenital cytomegalovirus infection with neurological sequelae: A retrospective study using umbilical cord

Mitsugu Uematsu, Kazuhiro Haginoya, Atsuo Kikuchi, Naomi Fukuyo, Keiko Ishii, Takashi Shiihara, Mitsuhiro Kato, Atsushi Kamei, Shigeo Kure

Research output: Contribution to journalArticlepeer-review

10 Citations (Scopus)

Abstract

Background Congenital cytomegalovirus (CMV) infection causes various neurological sequelae. However, most infected infants are asymptomatic at birth, and retrospective diagnosis is difficult beyond the neonatal period. Objective This study aimed to investigate the aspects of neurological sequelae associated with asymptomatic congenital CMV infection. Methods We retrospectively analyzed 182 patients who were suspected of having asymptomatic congenital CMV infection with neurological symptoms in Japan. Congenital CMV infection was diagnosed by quantitative polymerase chain reaction amplification of CMV from dried umbilical cord DNA. Results Fifty-nine patients (32.4%) who tested positive for CMV were confirmed as having congenital CMV infection. Among 54 congenital CMV patients, major neurological symptoms included intellectual disability (n = 51, 94.4%), hearing impairment (n = 36, 66.7%) and cerebral palsy (n = 21, 38.9%), while microcephaly (n = 16, 29.6%) and epilepsy (n = 14, 25.9%) were less common. In a brain magnetic resonance imaging (MRI) study, cortical dysplasia was observed in 27 CMV-positive patients (50.0%), and all patients (100%) had cerebral white matter (WM) abnormality. Intracranial calcification was detected by CT in 16 (48.5%) of 33 CMV-positive patients. Cerebral palsy, cortical dysplasia and a WM abnormality with a diffuse pattern were associated with marked intellectual disability. Conclusions Brain MRI investigations are important for making a diagnosis and formulating an intellectual prognosis. Analysis of umbilical cord tissue represents a unique and useful way to retrospectively diagnose congenital CMV infection.

Original languageEnglish
Pages (from-to)819-826
Number of pages8
JournalBrain and Development
Volume38
Issue number9
DOIs
Publication statusPublished - 2016 Jan 1

Keywords

  • Asymptomatic
  • Congenital CMV infection
  • Intellectual disability
  • Magnetic resonance image
  • White matter abnormality

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Developmental Neuroscience
  • Clinical Neurology

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