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9/27/2014  |   10:00 AM - 10:30 AM   |  Wyoming

Lenticulostriated Vasculopathy is a Common Finding and Serves as a High Risk Marker of Hearing Loss in Congenital Cytomegalovirus Infection

Objective To investigate the relationship between lenticulostriated vasculopathy (LSV) and hearing loss in a large group of infants with congenital cytomegalovirus (cCMV). Study design All infants followed in our clinic for more than a year with cCMV with only LSV signs of brain involvement on initial brain ultrasound, were included. Group 1 comprised infants with no hearing impairment at birth, and not treated with gan/ valganciclovir during 2006-2009. Group 2 comprised all infants with LSV and no hearing impairment treated since mid-2009. Group 3 comprised infants born with LSV and hearing loss treated from birth during for the entire study period. Asymptomatic infants with cCMV born during the same time period were the controls (group 4). Hearing studies (BERA) were performed during the neonatal period and follow-up every 3-6 months. Results 141 infants were enrolled: group 1-13 infants, group 2-51, group 3-25 and group 4 -52. The first three groups were similar with respect to maternal primary vs. non-primary infection and time of maternal infection during pregnancy. Hearing deterioration occurred more extensively in group 1 infants compared with group 2 (85% vs. 0%,p<0.001), and compared with the asymptomatic group (85% vs. 10%,p<0.001). Hearing deterioration occurred more often in group 4 compared with group 2 (10% vs. 0%, p=0.008). Conclusions LSV is a common finding in infants with cCMV infection and may serve as a sign of CNS involvement and further hearing deterioration. We believe that early anti-viral treatment with gan/valganciclovir may be prudent to prevent hearing deterioration in these infants.

Efraim Bilavsky (Primary Presenter), yoji@netvision.net.il;
Pediatrician and infectious diseases expert. Senior physician, Department of Pediatrics “C”, Schneider Children’s Medical Center of Israel, Petah-Tikva, Israel. Associate Professor, Tel-Aviv University, Sackler School of Medicine, Tel-Aviv, Israel.

ASHA DISCLOSURE:

Financial - No relevant financial relationship exist.

Nonfinancial - No relevant nonfinancial relationship exist.

Jacob Amir (Author), amirj@clalit.org.il;
Born in Israel. Medical studies: Hebrew University, Hadassah School of Medicine Jerusalem, Israel. Residency: Department of Pediatrics, Rabin Medical Center, Beilinson Hospital, Petach Tiqva, Israel. 1987-1989 - Fellowship: Children’s Hospital, Washington University, St. Louis, Mo, USA in Pediatric Infectious Diseases Professor of Clinical Pediatrics, Tel Aviv University, Sackler School of Medicine, Tel Aviv, Israel Since 1998 - Head, Department of Pediatrics “C”, Schneider Children’s Medical Center of Israel, Petach Tiqva, Israel. Consultant for intrauterine infections at the Department of Obstetrics and Gynecology, Rabin Medical Center, Beilinson Hospital, Petach Tiqva, Israel. Main topics of clinical research include: HIB vaccine, nontuberculous lymphadenitis, post circumcision urinary tract infections, herpetic gingivostomatitis and congenital CMV infection- maternal consultation during pregnancy and post natal antiviral therapy.

Presentation:
317EfraimBilavsky.pdf

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