VIRAL ETIOLOGY OF INTUSSUSCEPTION IN TAIWANESE CHILDHOOD

Background, Adenovirus infection and lymphoid hyperplasia have been as sociated with childhood intussusception. However, the extent of other viruses involved in this condition remains unclear. This prospective s tudy investigates the relationship between some lymphotropic viruses a nd current childhood intussusception, Methods, Patients with intussusc eption encountered in a pediatric emergency department in a recent 3-y ear period were studied. Healthy infants and toddlers of comparable ag e served as controls. Throat and rectal viral cultures were performed in patients and controls, Viral antibodies against adenovirus, cytomeg alovirus, human herpesvirus (HHV)-6, HHV-7 and Epstein-Barr virus (EBV ) were tested in paired sera from the patients. Acute stage serum from each patient and mesenteric lymph nodes from patients requiring surge ry were studied for the presence of adenovirus genome by PCR, Results, Twenty-seven of 61 (44.3%) intussusception patients, but only 2 of 52 (3.8%) healthy controls shed nonenteric adenovirus in throat and rect al specimens (P < 0.001), Of the 27 (74.1%) patients who shed adenovir us, 20 were older than 1 year old, whereas only 1 of 15 (6.7%) similar ly aged patients in a previous study from the same area three decades ago did so (P 0.001). Among 43 patients with available paired sera, ac ute primary viral infection was found in 17 (39.5%) by adenovirus, 4 ( 9.3%) by HHV-6, 5 (11.6%) by HHV-7, 2 (4.7%) by EBV and none by cytome galovirus, Multiple viral infections occurred in 6 patients. Adenoviru s genome was detected in 4 of 9 mesenteric lymph nodes and in only 3 o f 60 (5%) acute phase sera. Conclusions. Primary nonenteric adenovirus infection contributes to current childhood intussusception. Acute pri mary HHV-6, HHV-7 and EBV infections also play etiologic roles.