Published online August 1, 2008
PEDIATRICS Vol. 122 No. 2 August 2008, pp. 392-397 (doi:10.1542/10.1542/peds.2007-2290)

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ARTICLE

Analysis of Rotavirus Antigenemia and Extraintestinal Manifestations in Children With Rotavirus Gastroenteritis

Ken Sugata, MD^a, Koki Taniguchi, PhD^b, Akiko Yui, BS^b, Fumi Miyake, MD^a, Sadao Suga, MD^a, Yoshizo Asano, MD^a, Masahiro Ohashi, MD^c, Kyoko Suzuki, MD^d, Naoko Nishimura, MD^e, Takao Ozaki, MD^e and Tetsushi Yoshikawa, MD^a

^a Departments of Pediatrics
^b Virology and Parasitology, Fujita Health University School of Medicine, Toyoake, Aichi, Japan
^c Department of Pediatrics, Kariya Toyota General Hospital, Kariya, Aichi, Japan
^d Department of Pediatrics, Toyokawa Municipal Hospital, Toyokawa, Aichi, Japan
^e Department of Pediatrics, Showa Hospital, Konan, Aichi, Japan

OBJECTIVE. This study was conducted to examine the association between rotavirus antigenemia and clinical features, particularly extraintestinal manifestations, and the association between serum cytokine levels and rotavirus antigen quantity.

METHODS. Sixty hospitalized children who received a diagnosis of acute rotavirus gastroenteritis were enrolled in this study. Paired serum samples were collected from the 60 children when admitted to and discharged from the hospital. Associations among viral antigen levels and fever, elevated transaminase levels, and seizures were evaluated to determine whether antigenemia correlated with disease severity. Viral antigen was measured by using an in-house enzyme-linked immunosorbent assay that detected VP6 antigen. A flow-cytometric bead array was used to measure serum cytokine levels.

RESULTS. Rotavirus antigen levels were significantly higher in serum collected at the time of hospital admission than at the time of discharge. Serum rotavirus antigen levels peaked on day 2 of the illness (2.02 ± 0.73), followed by a gradual decrease in antigen levels to nearly undetectable levels by day 6. The quantity of rotavirus antigen was significantly higher in serum collected from patients with fever than those without fever. The presence or absence of elevated transaminase levels and seizures was not associated with serum rotavirus antigen levels. A weak but significantly positive association was observed between interleukin 8 levels and antigenemia. A weak but significantly negative association was observed between interleukin 10 levels and antigenemia.

CONCLUSIONS. Rotavirus antigenemia is frequently observed in a patient's serum during the acute phase, and viral antigen levels change dramatically during the acute phase of the illness. Because patients with fever had higher rotavirus antigen levels, antigenemia severity might contribute to fever. The host immune response plays an important role in controlling antigenemia levels.

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Key Words: rotavirus • antigenemia • cytokine

Abbreviations: ELISA—enzyme-linked immunosorbent assay • PBST—phosphate-buffered saline that contains Tween 20 • CBA—cytometric bead array • OD—optical density • IL—interleukin

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Accepted Dec 30, 2007.

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