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Cytomegalovirus Infection in Children: The Significance of CMV Specific IgM Antibody Test and Virus Isolation in the Urine

Journal of the Korean Pediatric Society 1992;35(7):890-901.
Published online July 15, 1992.
Cytomegalovirus Infection in Children: The Significance of CMV Specific IgM Antibody Test and Virus Isolation in the Urine
Dong Wook Kim, Hyun Kwack, Seong Hee Jang, I Seok Kang, Hoan Jong Lee, Jung-Hwan Choi, Jeong Kee Seo, Chong Ku Yun
Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea
소아의 거대세포바이러스 감염증: 거대세포바이러스 특이 IgM 항체 검사와 요중 바이러스 분리의 의의
김동욱, 곽현, 장성희, 강이석, 이환종, 최중환, 서정기, 윤종구
서울대학교 의과대학 소아과학교실
The clinical pictures of 44 children with IgM antibody to CMV (cytomegalovirus) by ELISA(enzyme linked immunosorbent assay) were reviewed retrospectively, and the significance of serum CMV specific IgM antibody and virus isolation in the urine was analyzed. Age of the patients with IgM antibody to CMV ranged from 23 days to 8 years 7 months, and median age was 2 months. Male to female ratio was 1.2:1. The clinical manifestations were hepatomegaly (79.5%), splenomegaly (54.5%), jaundice(54.5%), cough(27.3%), intercostal retraction(22.7%), rhinorrhea(20.5%), fever(15.9%), lymphadenopathy(9.0%), prematurity(4.5%), intrauterine growth retardation(4.5%), failure to thrive(2.3%), microcephaly(2.3%), etc. The abnormal laboratory findings included increased ALT/AST(81.8%) and bilirubin(59.1%), anemia(43.2%), relative lymphocytosis(22.7%), relative monocytosis(27.3%). The chest X-ray showed pneumonic infiltration in 10 cases(22.7%). Out of 29 children in whom CMV infection was suspected and serum CMV IgM antibody test and urinary CMV culture were done simultaneously, CMV was recovered in 11 children, while serum IgM antibody was detected in 4 of the 11 children with urinary CMV. Above results suggest that hepatitis and/or pneumonitis may be common manifestations of symptomatic CMV infecton in the infant, and CMV infection should be included in the differential diagnosis of unexplained hepatitis or pneumonitis. Viral culture may also be necessary for identification of acute CMV infection in addition to serum CMV IgM antibody determination.
Key Words: Cytomegalovirus, CMV IgM antibody, Hepatitis, Pneumonia

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