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Viral Load Before and After Exchange Transfusion in a Neonate with Hyperbilirubinemia and Congenital Cytomegalovirus Infection | OMICS International | Abstract
ISSN: 2165-7920

Journal of Clinical Case Reports
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Case Report

Viral Load Before and After Exchange Transfusion in a Neonate with Hyperbilirubinemia and Congenital Cytomegalovirus Infection

Kei Ohashi1, Koichi Ito1, Takeshi Endo1, Tokio Sugiura1*, Risa Awaya2, Tatenobu Goto2, Yoshiaki Nagaya1, Hiroko Ueda1, Rika Nagasaki1,
Takenori Kato1 and Shinji Saitoh1
1Department of Pediatrics and Neonatology, Graduate School of Medical Sciences, Nagoya City University, Nagoya, Japan
2Department of Pediatrics, Holy Spirit Hospital, Nagoya, Japan
Corresponding Author : Tokio Sugiura
Department of Pediatrics and Neonatology
Graduate School of Medical Sciences, Nagoya City University
1 Kawasumi, Mizuho-Cho, Mizuho-Ku, Nagoya 467-8601, Japan
Tel: +81 52 853 8246
Fax: +81 52 842 3449
E-mail: [email protected]
Received February 04, 2014; Accepted February 25, 2014; Published February 27, 2014
Citation: Ohashi K, Ito K, Endo T,Sugiura T, Awaya R, et al. (2014) Viral Load Before and After Exchange Transfusion in a Neonate with Hyperbilirubinemia and Congenital Cytomegalovirus Infection. J Clin Case Rep 4:343. doi:10.4172/2165-7920.1000343
Copyright: © 2014 Ohashi K, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Abstract

Introduction: Cytomegalovirus is the most common cause of intrauterine infection in developed countries. Between 10% and 15% of infants infected with congenital cytomegalovirus exhibits the clinically apparent or symptomatic form of the disease. Exchange transfusion is an established therapy for hyperbilirubinemia and severe anemia. However, to the best of our knowledge, the viral load of cytomegalovirus before and after exchange transfusion has not been previously reported.

Case report: A Japanese female was delivered at 36 weeks of gestation to a 29-year-old gravida 3 para 3 by emergency Cesarean section because of non-reassuring fetal status. Hepatomegaly, splenomegaly, generalized petechiae, leptocephaly, and jaundice were noted at birth. On admission, her total bilirubin was 14.2 mg/dL, cytomegalovirus immunoglobulin M was positive (4.63 mg/dL), and her head ultrasound and computed tomography showed left intraventricular calcification and bilateral ventriculomegaly. Toxoplasma, rubella, and herpes simplex virus serologies were negative. The exchange transfusion was performed for the treatment of early onset hyperbilirubinemia, not for the treatment of congenital cytomegalovirus infection. The cytomegalovirus viral load before and after exchange transfusion was investigated by real-time polymerase chain reaction, and the plasma viral
load of cytomegalovirus was not significantly decreased from before (8.7×105/mL) to after (4.3×105/mL) exchange transfusion.

Conclusion: Exchange transfusion did not reduce the viral load of cytomegalovirus in severe congenital
cytomegalovirus infection.

Keywords

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