乳児期の難治性喘鳴と後天性サイトメガロ ウイルス感染との関連  [in Japanese] Cytomegalovirus(CMV) Infection in Infants may Result Intractable Stridor  [in Japanese]

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Author(s)

Abstract

3カ月以上喘鳴をきたす10名の乳児を経験した. いずれもteophyllin製剤やβ刺激薬の反応は不良で, 3カ月以上にわたる喘鳴を認め, 入退院を繰り返していた. 全例白血球の増多を認め, 経過中にトランスアミナーゼの異常 (GOT, GPT上昇) を認めていた. 好中球殺菌能を検索した4例では2例で低下を認めた. IgE, RASTなどアレルギー検査結果は高値を示さず, さらに胸部レントゲン写真では間質性肺炎像や無気肺像を示すものもあった. 全例, サイトメガロウイルスIgM抗体陽性で, CF法も高値を示した. CMVPCRで唾液を検索し, 10例中7例が陽性であった. 気管支鏡を施行した3例では, 気管支洗浄液 (BAL) より2例でCMVが分離できた. CMVPCR陽性の検体はダイレクトシークエンス法にて1mmediateearly (IE) 領域の一部の塩基配列の決定を行い, silent mutationを認めた他はほぼ同じシークエンスであった. 乳児の長期喘鳴とCMV感染の関連が示唆され, CMVによる免疫機構への影響について検討が必要と思われた.

We found ten cases of human cytomegalovirus (CMV) infection who were intractable stridor. Their symptoms were not improved by the treatment with aminophyllin nor β stimulants. They were admitted repeatedly complaining of stridor, fever and diarrhea. In two cases, the immunological findings showed a decrease of bacterial sterilizing activity of the neutrophils. Additionally, blood count showed leukocytosis more than 15, 000/ul in all cases. Total serum IgE and specific IgE antibodies to many antigens were not elevated. Transaminase was elevated. Chest X-p findings of interstitial pneumonia or atelectasis continued for a long time in some cases. Virological examinations revealed high concentrations of specific IgM or CF antibodies against CMV in all cases. CMV DNA in saliva were examined by polymerase chain reaction (PCR) with primer sets for the immediate early (IE) region of CMV and showed positive in seven cases. CMV in bronchoalveolar lavage (BAL) was isolated in two cases, and CMV PCR in BAL was positive in three cases. The sequence of the CMV-PCR products showed almost same sequence except one point mutation in bp 1203.<BR>We considered that CMV infections in infants may induce stridor for a long period.

Journal

  • Kansenshogaku Zasshi

    Kansenshogaku Zasshi 74(8), 675-679, 2000-08-20

    The Japanese Association for Infectious Diseases

References:  10

Codes

  • NII Article ID (NAID)
    10008707537
  • NII NACSIS-CAT ID (NCID)
    AN00047715
  • Text Lang
    JPN
  • Article Type
    ART
  • ISSN
    03875911
  • NDL Article ID
    5454909
  • NDL Source Classification
    ZS9(科学技術--医学--病理学・微生物学・寄生虫学・感染・免疫学・血清学・アレルギー)
  • NDL Call No.
    Z19-193
  • Data Source
    CJP  NDL  J-STAGE 
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