Protein-losing enteropathy associated with rotavirus infection in an infant

doi:10.3748/wjg.14.1630

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Mar 14, 2008 (publication date) through Nov 27, 2024

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World Journal of Gastroenterology

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1007-9327

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

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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