Rotavirus infection in small bowel transplant

A histologic comparison with acute cellular rejection

Laurie J. Eisengart, Pauline M. Chou, Kishore Iyer, Valeria Cohran, Veena Rajaram

Research output: Contribution to journalArticle

17 Citations (Scopus)

Abstract

Pediatric small bowel transplant recipients are susceptible to diarrhea due to rejection or infectious enteritis, particularly of viral etiology. The most common causes of viral enteritis in this setting are rotavirus, adenovirus, cytomegalovirus, and Epstein-Barr virus. This study is the first to compare the histologic findings of rotavirus infection with acute cellular rejection in small bowel transplant biopsies. Three patients with small bowel transplants had rapid stool antigen test-proven rotavirus infection. Endoscopic biopsies during infection were examined, including material from the allograft, native small bowel, stomach, and colon. Biopsies from 2 of the patients during unrelated episodes of mild acute cellular rejection were also evaluated. Blunting of villi was the most common finding in rotavirus infection. Additionally, there was a mononuclear infiltrate that was ''top heavy,'' or denser towards the lumen. There were surface apoptoses but no increase in crypt apoptotic figures. In contrast, during mild acute cellular rejection, there was no villous blunting, the mononuclear infiltrate was diffuse, and there were increased crypt apoptosis. As expected, the changes of acute cellular rejection were confined to the graft, in contrast to rotavirus infection, in which case native bowel often had more pronounced changes. Although the small number of patients limits this study, several histologic features were helpful in identifying rotavirus infection. These were blunting of villi, distribution of the inflammatory infiltrate, number and location of apoptotic bodies, and anatomic location of the effect. A larger follow-up study would be valuable to confirm these findings.

Original languageEnglish (US)
Pages (from-to)85-88
Number of pages4
JournalPediatric and Developmental Pathology
Volume12
Issue number2
DOIs
StatePublished - Mar 2009

Fingerprint

Rotavirus Infections
Transplants
Enteritis
Biopsy
Apoptosis
Rotavirus
Cytomegalovirus
Human Herpesvirus 4
Adenoviridae
Allografts
Diarrhea
Stomach
Colon
Pediatrics
Antigens
Infection

Keywords

  • Infectious enteritis
  • Rejection
  • Rotavirus
  • Transplantation

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Pathology and Forensic Medicine

Cite this

Rotavirus infection in small bowel transplant : A histologic comparison with acute cellular rejection. / Eisengart, Laurie J.; Chou, Pauline M.; Iyer, Kishore; Cohran, Valeria; Rajaram, Veena.

In: Pediatric and Developmental Pathology, Vol. 12, No. 2, 03.2009, p. 85-88.

Research output: Contribution to journalArticle

Eisengart, Laurie J. ; Chou, Pauline M. ; Iyer, Kishore ; Cohran, Valeria ; Rajaram, Veena. / Rotavirus infection in small bowel transplant : A histologic comparison with acute cellular rejection. In: Pediatric and Developmental Pathology. 2009 ; Vol. 12, No. 2. pp. 85-88.
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