Evaluation of anatomic changes in young children with natural rotavirus infection: is intussusception biologically plausible?
BACKGROUND
Several studies have shown an association between vaccination with the rotavirus vaccine and the development of intussusception. We evaluated the plausibility of a causal association between natural rotavirus infection and intussusception.


METHODS
We performed ultrasound measurements, in infants with confirmed rotavirus infection and in healthy control subjects, of the ileum wall thickness and mesenteric lymph nodes, at enrollment and 1 month later.


RESULTS
Thirteen pairs of patients with rotavirus infection and control subjects were enrolled. The mean distal ileum wall thickness at the first examination was 3.0 mm in patients with rotavirus infection and 2.0 mm in control subjects (P = .037). The maximum lymph node size in patients with rotavirus infection was 11.6 mm at the first examination and 7.4 mm at the second examination (P = .017). Nodal aggregates and free fluid were also observed more commonly among patients with rotavirus infection (54% vs. 9%; P = .033 for both).


CONCLUSIONS
Rotavirus infection was associated with increased distal ileum wall thickness and lymphadenopathy during the illness period. These changes suggest a plausible mechanism by which rotavirus infection could cause intussusception.
Robinson
Christine G
CG
Pediatric Clinical Research Office, Nashville, Tennessee 37232, USA.
Hernanz-Schulman
Marta
M
Zhu
Yuwei
Y
Griffin
Marie R
MR
Gruber
William
W
Edwards
Kathryn M
KM
D016022:Case-Control Studies; D015331:Cohort Studies; D003108:Colonic Diseases / Q000000981:diagnostic imaging / Q000473:pathology / Q000821:virology*; D005260:Female; D006801:Humans; D007077:Ileal Diseases / Q000000981:diagnostic imaging / Q000473:pathology / Q000821:virology*; D007082:Ileum / Q000000981:diagnostic imaging / Q000473:pathology* / Q000821:virology; D007223:Infant; D007231:Infant, Newborn; D007443:Intussusception / Q000000981:diagnostic imaging / Q000473:pathology / Q000821:virology*; D008198:Lymph Nodes / Q000000981:diagnostic imaging / Q000473:pathology / Q000821:virology; D008297:Male; D010865:Pilot Projects; D011446:Prospective Studies; D012401:Rotavirus / Q000254:growth & development*; D012400:Rotavirus Infections / Q000000981:diagnostic imaging / Q000473:pathology* / Q000821:virology; D022243:Rotavirus Vaccines / Q000009:adverse effects; D014463:Ultrasonography
D022243:Rotavirus Vaccines