Beta₂-microglobulin concentrations in cerebrospinal fluid correlate with neuroimaging findings in newborns with symptomatic congenital cytomegalovirus infection

Authors: Alarcon, Ana¹; Garcia-Alix, Alfredo²; Cabañas, Fernando; Hernanz, Angel; Pascual-Salcedo, Dora; Martin-Ancel, Ana; Cabrera, Marta; Tagarro, Alfredo; Quero, Jose

Source: European Journal of Pediatrics, Volume 165, Number 9, September 2006 , pp. 636-645(10)

Publisher: Springer

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Abstract:

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 Beta₂-microglobulin (β₂-m) levels.

The objectives of this study were: (1) to determine whether CSF β₂-m is increased in newborns with symptomatic congenital CMV infection, and (2) to examine its correlation with neuroimaging findings.

Fourteen newborns with symptomatic congenital CMV infection admitted to La Paz Hospital from 1990 through 2004 underwent determination of CSF β₂-m. Ninety-three newborns, constituting the comparison group, underwent CSF β₂-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.

CSF β₂-m was increased in newborns with CMV infection (median 6.21 mg/L) compared with controls (1.68 mg/L) (P<.001). β₂-m showed a correlation with neuroimaging scores (r _s=0.753, P=.002). β₂-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 β₂-m is increased in newborns with symptomatic congenital CMV infection and correlates with neuroimaging abnormalities. β₂-m appears to be an indicator of the severity of brain involvement in congenital CMV infection.

Keywords: Beta2-microglobulin; Cerebrospinal fluid; Cytomegalovirus; Neuroimaging; Newborn

Document Type: Research article

DOI: http://dx.doi.org/10.1007/s00431-006-0160-x

Affiliations: 1: Email: luisiana12@terra.es 2: Email: alfredoalix@terra.es

Publication date: 2006-09-01