Adenovirus infection: A potential risk for developing intussusception in pediatric patients

Abstract

The pathogenesis of intussusception without obvious anatomical leading points remains unclear. The objective of this study was to determine a feasibility of association between certain gastroenteritis viruses and intussusception. This was a prospective cohort study. Forty intussusception cases and 136 acute gastroenteritis controls with comparable age and gender were separately consecutively enrolled and relevant clinical data of both groups were recorded. The clinical specimens collected from all patients were screened for adenovirus, rotavirus, norovirus, and astrovirus by PCR and RT-PCR using specific primers. The genomes of detected viruses were characterized further to identify their genotypes by nucleotide sequencing. In 40 intussusception cases, adenovirus, rotavirus, and norovirus were detected in 12 (30.0%), 2 (5.0%), and 2 (5.0%), respectively while astrovirus was undetectable. In contrast, 136 acute gastroenteritis patients, adenovirus, rotavirus, and norovirus were detected in 11 (8.1%), 24 (17.7%), and 24 (17.7%) patients, respectively and again astrovirus was undetectable. The detection of adenovirus in intussusception patients was significantly higher than those in the control group (P < 0.001) with an odd ratio of 4.87 (95%CI: 1.95, 12.16). Interestingly, molecular analysis of adenovirus genome demonstrated that all of adenovirus detected in intussusception patients belonged to adenovirus C. This could be a potential risk factor or pathogenesis for developing intussusception in the cases of those without apparent anatomical leading points. J. Med. Virol. 88:1930-1935, 2016. © 2016 Wiley Periodicals, Inc.

Epigenetics and the dynamics of chromatin during adenovirus infections

“…Persistently infected lymphocytes in the gastrointestinal tract are the primary source of disseminated adenoviral infections after pediatric allogeneic stem cell transplants (see Lion review [182]). Adenovirus DNA was associated with nearly one-third of the cases of intussusception lacking anatomical irregularities associated with this disease [184]. A greater understanding of the signals that govern latency and persistence would aid in the prevention of the emergence of this life-threatening infection when immunosuppression cannot be avoided.…”

“…Intussusception, in which a segment of intestine 'telescopes' into another segment causing intestinal blockage, is the most common abdominal crisis in young children [183]. Adenovirus DNA was associated with nearly one-third of the cases of intussusception lacking anatomical irregularities associated with this disease [184]. Both molecular and epidemiological analyses identified nonenteric adenoviruses as a risk factor for intussusception [185].…”

Probiotic use in acute viral gastroenteritis: Is it really effective?

“…Death is mostly due to severe fluid electrolyte losses because of late diagnosis and inadequate treatment. The key point in preventing morbidity and mortality is to prevent the loss of fluid-electrolyte or make timely diagnosis and timely treatment [1,4,7,9,10]. Otherwise, death from hypovolemic shock is inevitable.…”

“…Probiotics are live digestive system bacteria that provide health benefits to the host. They may inhibit the localization of pathogenic bacteria by colonizing bowel epithelium [3,[10][11][12][13][14]. Probiotics can be effective in the treatment and prevention of gastroenteritis.…”

“…Probiotics especially Bifidobacterium Lactis and Saccaromyces spp or their combination forms are found effective in acute viral gastroenteritis. In the literature, it is reported that using of probiotics benefits both inpatient and outpatient in acute viral diarrhea [2,[10][11][12][13][14][15]. The aim of this study is to determine the effect of probiotics on the severity and duration of the complaints in children aged between 2 and 5 years who were treated in our clinic with the diagnosis of acute viral gastroenteritis in early childhood morbidity and mortality.…”