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Boletín Médico del Hospital Infantil de México

2009, Number 2

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Bol Med Hosp Infant Mex 2009; 66 (2)

Neonatal non-obstructive cholestasis associated to cytomegalivirus infection. Long-term follow-up of a series of cases of the Hospital Infantil of Mexico Federico Gomez

Consuelo-Sánchez A, Baca-Rodríguez LW, Roque-Lee G, Valencia-Mayoral PF

Language: Spanish
References: 21
Page: 141-152
PDF size: 148.88 Kb.


ABSTRACT

Introduction. Neonatal hepatitis (NH) and cytomegalovirus (CMV) infection are associated. Long-term evolution of NH is unknown. Hearing loss is a late complication of this infection. Objective: To evaluate the behavior of hepatic damage and hearing functions in patients of the Hospital Infantil de Mexico who developed NH associated to CMV infection.
Methods. Clinical charts of children older than 18 months of age with a history of NH and CMV infection were analyzed over the period 01/01/1990-12/31/2005. Cases of biliary atresia or genetic defects were excluded. Candidates for the study were contacted by telephone and invited for a new clinical, biochemical and hearing evaluation.
Results. Twenty patients were included. Jaundice lasted no more than 11 months in none of these patients. Hepatitis was auto-limited before 6 months in 40%, and before 1 year in 20%. Raised alaninaminotransferase persisted longer than 1 year in 20% of patients, and became normal at 4 years of age in half of the patients. One patient developed autoimmune hepatitis. Twenty percent had unilateral or bilateral hearing loss of variable intensity. Four patients received ganciclovir treatment, 1 developed hearing loss, and 2 had a prolonged hepatitis.
Conclusions. NH associated to CMV infection may have a long-term evolution in nearly 40% of patients. Hearing loss was present in 20% of our cases. Hepatitis and hearing function must be monitored on a long term basis in these patients.


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