Case Report
Copyright ©2008 The WJG Press and Baishideng. All rights reserved.
World J Gastroenterol. Mar 14, 2008; 14(10): 1630-1632
Published online Mar 14, 2008. doi: 10.3748/wjg.14.1630
Protein-losing enteropathy associated with rotavirus infection in an infant
Tadashi Iwasa, Nobuyuki Matsubayashi
Tadashi Iwasa, Department of Pediatrics, Mie University Graduate School of Medicine, Tsu, Mie, Japan
Nobuyuki Matsubayashi, Department of Pediatrics, Shima Prefectural Hospital, Shima, Mie, Japan
Author contributions: Tadashi I and Nobuyuki M contributed equally to this work; Tadashi Iwasa wrote the paper.
Correspondence to: Tadashi Iwasa, MD, Department of Pediatrics, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu City, Mie Prefecture, 514-8507, Japan. masaru@clin.medic.mie-u.ac.jp
Telephone: +81-59-2315024
Fax: +81-59-2315213
Received: October 29, 2007
Revised: November 17, 2007
Published online: March 14, 2008
Abstract

Rotavirus is an acute enteric pathogen in infants and children. We reported a rare case of a 6-mo-old infant with protein-losing enteropathy (PLE) caused by rotavirus gastroenteritis, and evaluated the immunological profile in peripheral blood lymphocytes. Laboratory examinations showed lymphopenia, hypoproteinemia, hypoalbuminemia, hypogammaglobulinemia, and elevation of alpha-1-antitrypsin (γ1-AT) clearance. Lymphocytes subpopulation study revealed the reversal of CD4+/CD8+ ratio with the selective decrease of CD4-positive lymphocytes. Moreover, the excessive increase of T cells producing IFN-gamma (IFN-γ) was found, which plays an important role in the protection against viral infection. The primary or secondary activation of immune system by rotavirus may influence structural integrity and vascular permeability, which may play a triggering role in protein-losing enteropathy.

Keywords: Protein-losing enteropathy; Rotavirus; Lymphocytes producing IFN-γ; Alpha-1-antitrypsin; Reversal of CD4+/CD8+ ratio