Relationship between adenovirus infection and intussusception via pathological evidence confirms.

Abstract

Aims: Although some cases of intussusception in older children are associated with pathological changes such as lymphoma or polyps, the cause of most cases in infants is unknown. Several reports have identified an association between adenovirus infection and intussusception in children. However, much of the evidence is indirect, such as stool samples or throat swab data. Our study analysed intestinal tissue, which may be more direct evidence of the relationship between adenovirus infection and intussusception.

Methods: We retrospectively reviewed children<6 years of age with intussusception who underwent surgery for failed reduction. The pathological tissue was processed into formalin-fixed paraffin-embedded (FFPE) sections. Adenovirus immunohistochemistry (IHC) and PCR testing were performed to obtain direct evidence of the relationship between adenovirus infection and intussusception.

Results: Our study included 29 patients, 27 appendiceal and 8 intestinal tissues. Only eight appendix specimens were successfully processed into FFPE tissue. IHC testing was positive in three cases (37.5%), and PCR testing was positive for adenovirus type C in four cases (50%). The control group consisted of eight children <6 years who underwent incidental appendectomies, and all control subjects had negative IHC and PCR analyses. PCR is as useful and reliable as IHC in diagnosing adenovirus in intussusception and has greater sensitivity than IHC.

Conclusion: We directly confirmed the relationship between adenovirus infection and intussusception through IHC analysis and PCR detection of pathological evidence. PCR is more sensitive than IHC for diagnosing adenovirus in intussusception.