T Vesikari, Vaccine Research Center, University of Tampere Medical School, Biokatu 10, FIN-33520 Tampere, Finland. Tel: +358 50 524 6530 | Fax: +358 3 3551 8450 | Email: [email protected]

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Abstract

Aim: This prospective study investigated the role of viral infections in the pathogenesis of intussusception, including human herpesvirus 6 (HHV-6), a known lymphotropic virus.

Methods: Fifty-three children with intussusception treated in hospital were enroled, and children of comparable age and gender served as controls. Blood, stool and throat swab specimens, as well as mesenteric lymph nodes and pieces of intestine from patients requiring surgery were tested for various viruses by PCR methods.

Results: Altogether, 85% of intussusception cases showed evidence of a recent or ongoing viral infection. Among the 53 intussusception cases, adenovirus was detected in 25 (47%), HHV-6 in 24 (45%), rhinovirus in 12 (23%), cytomegalovirus in 7 (13%), enterovirus in 4 (8%) and rotavirus in 3 (6%) patients. Of the 50 whole blood samples, 44% were positive for HHV-6 and of the 16 resected mesenteric lymph nodes, 50% were positive for HHV-6. Simultaneous presence of HHV-6 and adenovirus infection correlated significantly with intussusception (OR 12.1, 95% CI 2.2 to 66.5).

Conclusions: A statistically significant association was observed between adenovirus and childhood intussusception. HHV-6 was a common finding and occurred concomitantly with other viruses. A simultaneous infection with HHV-6 and adenovirus carried the highest risk for intussusception.

Refereces

1 Murphy TV, Gargiullo PM, Massoudi MS, Nelson DB, Jumaan AO, Okoro CA, et al. Intussusception among infants given an oral rotavirus vaccine. N Engl J Med 2001; 344: 564–72.
10.1056/NEJM200102223440804
CAS PubMed Web of Science® Google Scholar
2 Kramarz P, France EK, Destefano F, Black SB, Shinefield H, Ward JI, et al. Population-based study of rotavirus vaccination and intussusception. Pediatr Infect Dis J 2001; 20: 410–6.
10.1097/00006454-200104000-00008
CAS PubMed Web of Science® Google Scholar
3 Centers for Disease Control and Prevention. Withdrawal of rotavirus vaccine recommendation. MMWR 1999; 48: 1007.
PubMed Web of Science® Google Scholar
4 Vesikari T, Matson DO, Dennehy P, Van Damme P, Santosham M, Rodriguez Z, et al. Safety and efficacy of a pentavalent human-bovine (WC3) reassortant rotavirus vaccine. N Engl J Med 2006; 354: 23–33.
10.1056/NEJMoa052664
CAS PubMed Web of Science® Google Scholar
5 Ruiz-Palacios GM, Pérez-Schael I, Velázquez FR, Abate H, Breuer T, Clemens SC, et al. Safety and efficacy of an attenuated vaccine against severe rotavirus gastroenteritis. N Engl J Med 2006; 354: 11–22.
10.1056/NEJMoa052434
CAS PubMed Web of Science® Google Scholar
6 Centers for Disease Control and Prevention. Statement regarding Rotarix® and RotaTeq® rotavirus vaccines and intussusception. Available at: http://www.cdc.gov/vaccines/vpd-vac/rotavirus/intussusception-studies-acip.htm. Accessed November 17, 2010.
Google Scholar
7 Simonsen L, Viboud C, Elixhauser A, Taylor RJ, Kapikian AZ. More on RotaShield and intussusception: the role of age at the time of vaccination. J Infect Dis 2005; 192(Suppl 1): S36–43.
10.1086/431512
PubMed Web of Science® Google Scholar
8 Kombo LA, Gerber MA, Pickering LK, Atreya CD, Breiman RF. Intussusception, infection, and immunization: summary of a workshop on rotavirus. Pediatrics 2001; 108: E37.
10.1542/peds.108.2.e37
CAS PubMed Web of Science® Google Scholar
9 Fischer TK, Bihrmann K, Perch M, Koch A, Wohlfahrt J, Kåre M, et al. Intussusception in early childhood: a cohort study of 1.7 million children. Pediatrics 2004; 114: 782–5.
10.1542/peds.2004-0390
PubMed Web of Science® Google Scholar
10 Kim G, Daneman A, Alton DJ, Myers M, Sandler A, Superina R. The appearance of inverted Meckel diverticulum with intussusception on air enema. Pediatr Radiol 1997; 27: 647–50.
10.1007/s002470050204
CAS PubMed Web of Science® Google Scholar
11 Bell TM, Steyn JH. Viruses in lymph nodes of children with mesenteric adenitis and intussusception. Br Med J 1962; 2: 700–2.
10.1136/bmj.2.5306.700
CAS PubMed Google Scholar
12 Danis RK. Lymphoid hyperplasia of the ileum--always benign disease? Am J Dis Child 1974; 127: 656–62.
CAS PubMed Web of Science® Google Scholar
13 Hsu HY, Kao CL, Huang LM, Ni YH, Lai HS, Lin FY, et al. Viral etiology of intussusception in Taiwanese childhood. Pediatr Infect Dis J 1998; 17: 893–8.
10.1097/00006454-199810000-00009
CAS PubMed Web of Science® Google Scholar
14 Guarner J, de Leon-Bojorge B, Lopez-Corella E, Ferebee-Harris T, Gooding L, Garnett CT, et al. Intestinal intussusception associated with adenovirus infection in Mexican children. Am J Clin Pathol 2003; 120: 845–50.
10.1309/LBRNGF9MJW2MHT97
PubMed Web of Science® Google Scholar
15 Selvaraj G, Kirkwood C, Bines J, Buttery J. Molecular epidemiology of adenovirus isolates from patients diagnosed with intussusception in Melbourne, Australia. J Clin Microbiol 2006; 44: 3371–3.
10.1128/JCM.01289-06
CAS PubMed Web of Science® Google Scholar
16 Konno T, Suzuki H, Kutsuzawa T, Imai A, Katsushima N, Sakamoto M, et al. Human rotavirus infection in infants and young children with intussusception. J Med Virol 1978; 2: 265–9.
10.1002/jmv.1890020310
CAS PubMed Web of Science® Google Scholar
17 Jakab F, Péterfai J, Verebély T, Meleg E, Bányai K, Mitchell DK, et al. Human astrovirus infection associated with childhood intussusception. Pediatr Int 2007; 49: 103–5.
10.1111/j.1442-200X.2007.02293.x
CAS PubMed Web of Science® Google Scholar
18 Zupancic JA, Pennie RA, Issenman R. Intussusception in a child with cytomegalovirus infection. Pediatr Infect Dis J 1994; 13: 548–9.
10.1097/00006454-199406000-00020
CAS PubMed Web of Science® Google Scholar
19 Asano Y, Yoshikawa T, Suga S, Hata T, Yamazaki T, Yazaki T. Simultaneous occurrence of human herpesvirus 6 infection and intussusception in three infants. Pediatr Infect Dis J 1991; 10: 335–7.
10.1097/00006454-199104000-00015
CAS PubMed Web of Science® Google Scholar
20 Vesikari T, Karvonen A, Prymula R, Schuster V, Tejedor JC, Cohen R, et al. Efficacy of human rotavirus vaccine against rotavirus gastroenteritis during the first 2 years of life in European infants: randomised, double-blind controlled study. Lancet 2007; 370: 1757–63.
10.1016/S0140-6736(07)61744-9
CAS PubMed Web of Science® Google Scholar
21 Pang XL, Preiksaitis JK, Lee B. Multiplex real time RT-PCR for the detection and quantitation of norovirus genogroups I and II in patients with acute gastroenteritis. J Clin Virol 2005; 33: 168–71.
10.1016/j.jcv.2004.12.014
CAS PubMed Web of Science® Google Scholar
22 Allard A, Albinsson B, Wadell G. Detection of adenoviruses in stools from healthy persons and patients with diarrhea by two-step polymerase chain reaction. J Med Virol 1992; 37: 149–57.
10.1002/jmv.1890370214
CAS PubMed Web of Science® Google Scholar
23 Pang XL, Joensuu J, Hoshino Y, Kapikian AZ, Vesikari T. Rotaviruses detected by reverse transcription polymerase chain reaction in acute gastroenteritis during a trial of rhesus-human reassortant rotavirus tetravalent vaccine: implications for vaccine efficacy analysis. J Clin Virol 1999; 13: 9–16.
10.1016/S1386-6532(98)00013-4
CAS PubMed Web of Science® Google Scholar
24 Puustinen L, Blazevic V, Huhti L, Szakal ED, Halkosalo A, Salminen M, et al. Norovirus genotypes in endemic acute gastroenteritis of infants and children in Finland between 1994 and 2007. Epidemiol Infect 2011; 14: 1–8.
Google Scholar
25 Kares S, Lönnrot M, Vuorinen P, Oikarinen S, Taurianen S, Hyöty H. Real-time PCR for rapid diagnosis of entero- and rhinovirus infections using LightCycler. J Clin Virol 2004; 29: 99–104.
10.1016/S1386-6532(03)00093-3
CAS PubMed Web of Science® Google Scholar
26 Deffernez C, Wunderli W, Thomas Y, Yerly S, Perrin L, Kaiser L. Amplicon sequencing and improved detection of human rhinovirus in respiratory samples. J Clin Microbiol 2004; 42: 3212–8.
10.1128/JCM.42.7.3212-3218.2004
CAS PubMed Web of Science® Google Scholar
27 Grimm AC, Cashdollar JL, Williams FP, Fout GS. Development of an astrovirus RT-PCR detection assay for use with conventional, real-time, and integrated cell culture/RT-PCR. Can J Microbiol 2004; 50: 269–78.
10.1139/w04-012
CAS PubMed Web of Science® Google Scholar
28 Ward RL, Bernstein DI, Shukla R, Young EC, Sherwood JR, McNeal MM, et al. Effects of antibody to rotavirus on protection of adults challenged with a human rotavirus. J Infect Dis 1989; 159: 79–88.
10.1093/infdis/159.1.79
CAS PubMed Web of Science® Google Scholar
29 Komura E, Hashida T, Otsuka T, Kondo K, Yamanishi K, Hibi S, et al. Human herpesvirus 6 and intussusception. Pediatr Infect Dis J 1993; 12: 788–9.
10.1097/00006454-199309000-00024
CAS PubMed Web of Science® Google Scholar
30 Koranyi KI, Chapman J, Scherzer D. Irritability and vomiting in a five-month-old. Pediatr Infect Dis J 1997; 16: 1186.
10.1097/00006454-199712000-00020
CAS PubMed Web of Science® Google Scholar

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Volume101, Issue6

June 2012

Pages 663-670

Simultaneous presence of human herpesvirus 6 and adenovirus infections in intestinal intussusception of young children

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Simultaneous presence of human herpesvirus 6 and adenovirus infections in intestinal intussusception of young children

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