Rani pokazatelji neurorazvojnoga ishoda djece s konatalnom citomegalovirusnom infekcijom

doctoral thesis

• Title (english): Early predictors of neurodevelopmental outcome in children with congenital cytomegalovirus infection
• Author: Ivana Đaković
• Mentor: Ivica Kostović (mentor)
• Mentor: Vlatka Mejaški-Bošnjak (komentor)
• Committee member: Boris Filipović-Grčić (predsjednik povjerenstva)
• Committee member: Goran Tešović (član povjerenstva)
• Committee member: Nataša Beader (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Pediatrics); Zagreb
• Defense date and country: 2025-03-24, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Pediatrics
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Basic Medical Sciences; Neuroscience
• Universal decimal classification (UDC): 61 - Medical sciences

Abstract

Konatalna citomegalovirusna infekcija je najčešća vertikalno prenošena zarazna bolest. U zaražene djece je često asimptomatska, ali može biti uzrokom teških neurorazvojnih odstupanja kao što su poremećaji sluha i vida, motoričko odstupanje do razvoja cerebralne paralize, intelektualno oštećenje, epilepsija ili poremećaj iz spektra autizma. Budući da se probir novorođenčadi na konatalnu citomegalovirusnu infekciju ne provodi sustavno, sumnja na infekciju u većini slučajeva se postavlja temeljem kliničke slike. Studijom je obuhvaćeno 103 djece s dokazanom infekcijom čiji je razvoj praćen 4-17,9 godina. Prosječna dob postavljanja sumnje na infekciju je u skupini djece sa simptomatskom infekcijom bila 3,3 mjeseca, a u skupini djece s asimptomatskom infekcijom 5,1 mjesec. Simptomi temeljem kojih je postavljena sumnja na infekciju, a povezani su s lošim neurorazvojnim ishodom, su bili mikrocefalija i oštećenje sluha. Utvrđeno je da djeca sa simptomatskom infekcijom imaju značajno lošiji ukupni neurorazvojni ishod od djece s asimptomatskom infekcijom, iako je loš ishod moguć i u asimptomatskoj skupini. Mikrocefalija je kao početni simptom, ali i kao jedan od ishoda infekcije, značajno povezana s lošim neurorazvojnim ishodom i s teškim oštećenjem mozga. Zbog moguće progresije bolesti, osobito oštećenja sluha, konatalno inficirana djeca zahtijevaju dugotrajno praćenje. S obzirom na nemogućnost pravodobnog otkrivanja djece s KCMVI predlaže se provođenje sveobuhvatnog ili ciljanog novorođenačkog probira.

Abstract (english)

Congenital cytomegalovirus infection is the most common vertically transmitted infectious disease. Infected children are often asymptomatic, but infection can also cause severe neurodevelopmental disorders such as hearing and visual impairments, cerebral palsy, intellectual impairment, epilepsy or autism. Since no universal screening for congenital cytomegalovirus infection is performed, diagnosis is usually set by clinical appearance of early clinical simptoms of infection. Study described 103 children with proven congenital cytomegalovirus infection folowed for 4-17,9 years. The average age at which infection was suspected was 3.3 months in the group of children with symptomatic infection, and 5.1 months in the group of children with asymptomatic infection. Symptoms which raised the clinical suspicion and were associated with a poor neurodevelopmental outcome, were microcephaly and hearing impairment. Children with symptomatic infection had significantly worse neurodevelopmental outcome than children with asymptomatic infection, although a poor outcome was also possible in the asymptomatic group. Microcephaly, as an initial symptom, but also as one of the outcomes of the infection, was significantly associated with poor neurodevelopmental outcome and severe brain damage. Due to the possible progression of the disease, especially hearing impairment, congenitaly infected children require long-term follow-up. Due to failure of timely detection of children with congenital cytomegalovirus infection, comprehensive or targeted newborn screening is suggested.

• Keywords: Novorođenče; Mikrocefalija; Autistični poremećaj; Cerebralna paraliza; Asimptomatske infekcije; Sluh; Infekcije citomegalovirusom; Neurorazvojni poremećaji; Malformacije živčanog sustava; Gubitak sluha; Zarazne bolesti; Poremećaji vida; Epilepsija; Mozak
• Keywords (english): Newborn; Microcephaly; Autistic Disorder; Cerebral Palsy; Asymptomatic Infections; Hearing; Cytomegalovirus Infections; Neurodevelopmental Disorders; Nervous System Malformations; Hearing Loss; Communicable Diseases; Vision Disorders; Epilepsy; Brain
• Language: croatian
• URN:NBN: urn:nbn:hr:105:863729
• Study programme: Title: Biomedicine and Health Sciences; Study programme type: university; Study level: postgraduate; Academic / professional title: doktor/doktorica znanosti, područje biomedicine i zdravstvo (doktor/doktorica znanosti, područje biomedicine i zdravstvo)
• Type of resource: Text
• Extent: 96 str.
• File origin: Born digital
• Access conditions: Open access
• Created on: 2025-04-02 12:41:33