新生儿筛查低t细胞受体切除圆环的婴儿巨细胞病毒和EBV感染的发病率和危险因素

IF 4.5 3区医学 Q2 IMMUNOLOGY

Clinical immunology Pub Date : 2025-04-30 DOI:10.1016/j.clim.2025.110510

Megan E. Day-Lewis , Laura Berbert , Michele DeGrazia , Christina Yee , Ari J. Fried , Alan A. Nguyen , Jaime E. Hale , Anne Counihan , Anne Marie Comeau , Elsa R. Treffeisen , Mary Poyner Reed , Craig D. Platt , Janet Chou

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引用次数: 0

摘要

背景：使用T细胞受体切除环（trec）筛查新生儿严重联合免疫缺陷（SCID），可识别其他原因的淋巴细胞减少患者。非scid淋巴细胞减少症患者机会性感染的风险尚不清楚。我们的目的是描述巨细胞病毒（CMV）和eb病毒（EBV）感染在低trec患者中的发病率和危险因素。方法回顾性分析289例TREC结果≥1项异常的患者。结果PCR检测出19例巨细胞病毒或EBV。大多数感染得到缓解（n = 13）。其中2人患有慢性病毒血症，4人因传播巨细胞病毒而死亡。危险因素包括未检测到trec、血缘、家族史、低NK、naïve CD4、naïve CD8细胞和植物血凝素。结论低trec患者中巨细胞病毒和EBV感染是罕见的，但一些可能受益于预防措施。考虑风险因素可能有助于决策和改善结果。

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Incidence and risk factors for CMV and EBV infection in infants with low T-cell receptor excision circles on newborn screen

Background

Newborn screening for severe combined immunodeficiency (SCID) using T cell receptor excision circles (TRECs) identifies patients with other causes of lymphopenia. The risk of opportunistic infection in patients with non-SCID lymphopenia is poorly understood. We aim to describe incidence and risk factors associated with cytomegalovirus (CMV) and Epstein-Barr virus (EBV) infection in patients with low TRECs.

Methods

This retrospective study analyzed 289 patients with ≥1 abnormal TREC result.

Results

Nineteen patients had CMV or EBV detected by PCR. Most had resolution of infection (n = 13). Two have chronic viremia, and four expired due to disseminated CMV. Risk factors included undetectable TRECs, consanguinity, family history, low NK, naïve CD4, naïve CD8 cells, and phytohemagglutinin.

Conclusion

Infection with CMV and EBV in patients with low TRECs is rare, however some may benefit from preventative measures. Consideration of risk factors may aid in decision-making and improve outcomes.

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来源期刊

Clinical immunology 医学-免疫学

CiteScore

12.30

自引率

1.20%

发文量

212

审稿时长

34 days

期刊介绍： Clinical Immunology publishes original research delving into the molecular and cellular foundations of immunological diseases. Additionally, the journal includes reviews covering timely subjects in basic immunology, along with case reports and letters to the editor.