Beta2-microglobulin concentrations in cerebrospinal fluid correlate with neuroimaging findings in newborns with symptomatic congenital cytomegalovirus infection.
BACKGROUND
In newborns with symptomatic congenital cytomegalovirus (CMV) infection, neuroimaging is the best available predictor of neurodevelopmental outcome. Cerebrospinal fluid (CSF) findings in congenital CMV infection have seldom been described. Neonates with central nervous system infections present high CSF Beta(2)-microglobulin (beta(2)-m) levels.


OBJECTIVE
The objectives of this study were: (1) to determine whether CSF beta(2)-m is increased in newborns with symptomatic congenital CMV infection, and (2) to examine its correlation with neuroimaging findings.


METHODS
Fourteen newborns with symptomatic congenital CMV infection admitted to La Paz Hospital from 1990 through 2004 underwent determination of CSF beta(2)-m. Ninety-three newborns, constituting the comparison group, underwent CSF beta(2)-m determination as part of a sepsis or meningo/encephalitis work-up, and at discharge had sterile cultures and normal neurological status. Neuroimaging findings were scored according to a semiquantitative system: (0) no abnormalities; (1) single punctate periventricular (PV) calcification and/or hyperechogenic areas in the thalamus and basal ganglia; (2) multiple discrete PV calcifications and/or ventriculomegaly; and (3) extensive PV calcifications and/or brain atrophy.


CONCLUSIONS
CSF beta(2)-m was increased in newborns with CMV infection (median 6.21 mg/L) compared with controls (1.68 mg/L) (P<.001). beta(2)-m showed a correlation with neuroimaging scores (r (s)=0.753, P=.002). beta(2)-m was higher in patients who scored 2-3 (12.83 mg/L) than in patients who scored 0-1 (5.52 mg/L) (P=.028). CSF beta(2)-m is increased in newborns with symptomatic congenital CMV infection and correlates with neuroimaging abnormalities. beta(2)-m appears to be an indicator of the severity of brain involvement in congenital CMV infection.
Alarcon
Ana
A
Department of Pediatrics, Division of Neonatology, Unitat Integrada Hospital Sant Joan de Deu-Hospital Clinic, Universitat de Barcelona, 08950 Barcelona, Spain. luisiana12@terra.es
Garcia-Alix
Alfredo
A
Cabañas
Fernando
F
Hernanz
Angel
A
Pascual-Salcedo
Dora
D
Martin-Ancel
Ana
A
Cabrera
Marta
M
Tagarro
Alfredo
A
Quero
Jose
J
D001034:Apgar Score; D001921:Brain / Q000002:abnormalities / Q000821:virology; D001927:Brain Diseases / Q000134:cerebrospinal fluid / Q000175:diagnosis / Q000821:virology; D002114:Calcinosis / Q000134:cerebrospinal fluid / Q000821:virology; D016022:Case-Control Studies; D002494:Central Nervous System Infections / Q000134:cerebrospinal fluid / Q000175:diagnosis / Q000821:virology; D003586:Cytomegalovirus Infections / Q000134:cerebrospinal fluid* / Q000150:complications / Q000151:congenital* / Q000175:diagnosis; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007231:Infant, Newborn; D008279:Magnetic Resonance Imaging; D008297:Male; D008590:Meningoencephalitis / Q000134:cerebrospinal fluid / Q000821:virology; D012107:Research Design; D012720:Severity of Illness Index; D013030:Spain; D014057:Tomography, X-Ray Computed; D017585:Ultrasonography, Doppler, Transcranial; D014766:Viremia / Q000134:cerebrospinal fluid / Q000821:virology; D001613:beta 2-Microglobulin / Q000134:cerebrospinal fluid*
D001613:beta 2-Microglobulin