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Journal Articles Nutrients Year : 2023

Clinical Manifestation of Cytomegalovirus-Associated Protein-Losing Enteropathy in Children

Claire Ferrua
  • Function : Author
Anais Lemoine
Alexis Mosca
  • Function : Author
Anne-Aurélie Lopes

Abstract

In children, CMV-associated protein-losing enteropathy (PLE) is characterised by a benign course and spontaneous healing but can lead to generalised oedema. Poorly defined, it is diagnosed after unnecessary invasive tests. Children with CMV-associated PLE between 2009 and 2019 in two French hospitals are retrospectively described. Clinical and biological signs, CMV identification, endoscopy and histological findings, disease management and course are analysed. CMV-associated PLE is proven in 21 immunocompetent and 22 immunosuppressed patients, with ages consistent with primo-infection and reactivation, respectively. The digestive symptoms prevail in immunocompetent children, mainly with vomiting (85.7% versus 50%, CI [1.2; 39.2], p = 0.02). Immunocompetent patients show more oedema (61.9% versus 4.5%, CI [3.6; 1502.4], p < 0.001), linked to more severe hypoalbuminemia (21.2 g/L [17.6–25.7] versus 29.6 g/L [24.9–33.9], p = 0.01). A severe course is observed in 23.8% of the immunocompetent patients and 54.5% of the immunosuppressed ones (p = 0.06). Evidence of CMV infection based on non-invasive methods is found on 88.9% of immunocompetent and 95.5% of immunosuppressed patients (p = 0.58), while endoscopy was performed on 95.2% and 100% of them, respectively (p = 0.48), without any therapeutic change. Thus, CMV-associated PLE should be suspected in children with generalised oedema. Not as benign as previously described, it can be confirmed using non-invasive tests.
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hal-04269164 , version 1 (03-11-2023)

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Claire Ferrua, Anais Lemoine, Alexis Mosca, Anne-Aurélie Lopes. Clinical Manifestation of Cytomegalovirus-Associated Protein-Losing Enteropathy in Children. Nutrients, 2023, 15 (13), pp.2844. ⟨10.3390/nu15132844⟩. ⟨hal-04269164⟩
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