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

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Abstract

Overview

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.

Objectives

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.

Materials and methods

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.

Discussion and conclusion

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.

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Acknowledgements

We are grateful to Dr. C. Roche, from the Division of Pediatric Neurology, Dr. M. Martinez Biarge, and rest of the staff of the Division of Neonatology for their valuable cooperation. We thank all the children and families that participated in this study.

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Authors and Affiliations

  1. Division of Neonatology, Department of Pediatrics, Hospital La Paz, Universidad Autonoma de Madrid, Paseo de la Castellana, 261, 28046, Madrid, Spain

    Alfredo Garcia-Alix, Fernando Cabañas, Angel Hernanz, Dora Pascual-Salcedo, Marta Cabrera, Alfredo Tagarro & Jose Quero

  2. Division of Neonatology, Department of Pediatrics, Unitat Integrada Hospital Sant Joan de Deu-Hospital Clinic, Universitat de Barcelona, 08950, Barcelona, Spain

    Ana Alarcon & Ana Martin-Ancel

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  1. Ana Alarcon
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  2. Alfredo Garcia-Alix
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Correspondence to Ana Alarcon.

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Alarcon, A., Garcia-Alix, A., Cabañas, F. et al. Beta2-microglobulin concentrations in cerebrospinal fluid correlate with neuroimaging findings in newborns with symptomatic congenital cytomegalovirus infection. Eur J Pediatr 165, 636–645 (2006). https://doi.org/10.1007/s00431-006-0160-x

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  • DOI: https://doi.org/10.1007/s00431-006-0160-x

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