V.A. VYALTSEVA, O.V. BORISOVA, E.A. MILOKHOVA, E.S. MENSHIKOVA

 Samara State Medical University, Samara

Contact details:

Vyaltseva V.A. — postgraduate student of the Department of Childhood Infections

Address: 89 Chapaevskaya St., 443099 Samara, Russian Federation, tel.: +7-927-893-42-50, e-mail: vialtceva.v@mail.ru

 Postnatally acquired cytomegalovirus infection (CMV) in infants often has mild or nonspecific symptoms, mimicking other conditions, which leads to delayed diagnosis and treatment. Identifying clinical and laboratory markers predicting the manifest form of the disease is a pressing challenge in pediatrics.

The purpose — to determine a set of clinical, laboratory, and instrumental predictors associated with the manifest form of postnatally acquired CMV in infants under three months of age.

Material and methods: A prospective comparative study was conducted. The main group (n = 46) consisted of children with verified postnatal CMV, divided into subgroups with manifest (n = 23) and latent (n = 23) course. The control group (n = 39) included children without markers of active CMV. We analyzed medical history, clinical picture, results of routine laboratory tests (CBC, biochemistry), immunological assays (IL-10, ELISA), PCR, and ultrasound.

Results. A specific symptom complex was characteristic of the manifest form: hepatosplenomegaly, prolonged jaundice, and muscle tone disorders. Laboratory predictors included a significant increase in ALT (>80 U/L) activity, thrombocytopenia (<150 × 10⁹/L), and elevated serum interleukin-10 levels (>5.0 pg/mL). Multivariate analysis identified independent predictors: elevated ALT (OR = 6.8), hyper-IL-10-emia (OR = 4.5), and splenomegaly on ultrasound (OR = 3.9).

Conclusion. Manifest postnatal CMV has a distinct clinical and laboratory profile. The identified predictors (elevated transaminases, thrombocytopenia, hyper-IL-10-emia, hepatosplenomegaly) can form the basis for a diagnostic algorithm to promptly identify children with an active infection requiring close monitoring and consideration of therapy.

Key words: cytomegalovirus postnatal infection, interleukin-10, predictors

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