Analysis of archived newborn dried blood spots (DBS) identifies congenital cytomegalovirus as a major cause of unexplained pediatric sensorineural hearing loss

作者：Meyer Lucy; Sharon Bazak; Huang Tina C; Meyer Abby C; Gravel Kristin E; Schimmenti Lisa A; Swanson Elizabeth C; Herd Hannah E; Hernandez Alvarado Nelmary; Coverstone Kirsten R; McCann Mark; Schleiss Mark R^*

来源：American Journal of Otolaryngology, 2017, 38(5): 565-570.

DOI：10.1016/jamjoto.2017.06.002

Purpose: Congenital cytomegalovirus (cCMV) infection is the most common non-genetic cause of sensorineural hearing loss (SNHL). However, accurate diagnosis of cCMV as the etiology of SNHL is problematic beyond the neonatal period. This study therefore examined whether cCMV infection could be identified retrospectively in children presenting with unexplained SNHL to a multidisciplinary diagnostic outpatient otolaryngology clinic at an academic medical center in Minnesota.
Methods: Over a 4-year period, 57 patients with an age range of 3 months to 10 years with unexplained SNHL were recruited to participate in this study. Informed consent was obtained to test the archived dried blood spots (DBS) of these patients for cCMV infection by real-time PCR, targeting a highly conserved region of the CMV UL83 gene. Results were normalized to recovery of an NRAS gene control. Chart review was conducted to identify subjects who underwent genetic testing and/or neurodiagnostic imaging to investigate possible genetic, syndromic, or anatomical causes of SNHL
Results: In total, 15 of the 57 children with unexplained SNHL tested positive for CMV DNA in their DBS (26%). A mean viral load of 8.3 x 10(4) (+/- 4.1 x 10(4)) [range, 1 x 103(-6) x 10(5)] copies/pg DNA was observed in subjects retrospectively diagnosed with cCMV. No statistically significant correlation was found between viral load and SNHL severity.
Conclusions: A retrospective DBS analysis demonstrated that 26% of patients presenting with unexplained SNHL in childhood had cCMV.

• 出版日期2017-10