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[Adenovirus and intranuclear inclusions in the appendix in children with acute intussusception]
D Berrebi1, L Ferkdadji, P Delagausie
1Service d'Anatomie et de Cytologie Pathologiques, Hôpital Robert Debré, Paris.
Insights
Pediatric intussusception cases frequently show viral inclusions in appendix tissue, specifically adenovirus. These findings suggest a viral link in some intussusception cases, though other causes remain unidentified.
Area of Science:
- Pediatric Gastroenterology
- Virology
- Surgical Pathology
Context:
- Intussusception is a common surgical emergency in children.
- The etiology of intussusception is not fully understood.
- Appendices are often removed during surgical reduction of intussusception.
Purpose:
- To investigate etiological factors of intussusception in pediatric appendices.
- To identify the presence of viral infections in appendices associated with intussusception.
Summary:
- Microscopic examination of 105 pediatric appendices from intussusception cases revealed viral inclusions in 45% of samples.
- Control appendices (n=30) showed no viral inclusions.
- Immunohistochemistry confirmed adenovirus as the causative agent in appendices with viral inclusions.
Impact:
- This study identifies adenovirus as a significant factor in pediatric intussusception.
- Highlights the role of viral infections in the etiology of intussusception.
- Suggests further research into non-viral causes of intussusception.
Abstract:
One hundred and five appendices removed at the time of surgical reduction of intussusception in children were studied by light microscopy after routine procedures to search for aetiological factors involved in intussusception. Normal pediatric appendix specimens served as controls (n = 30). Light microscopic examination showed viral inclusions in epithelial cells in 48 of 105 appendices (45%) from the cases of intussusception. No viral inclusion was observed in controls. Immunohistochemistry performed on 21 appendices from intussusception with a monoclonal antibody against adenovirus showed intranuclear positivity in all appendices with viral inclusions. Viral inclusions seen in epithelial cells of appendices from cases of intussusception are caused by virus and in particularly by adenovirus. The etiological factors involved in intussusception without viral inclusion in appendix remain unknown.