Cluster of neurological manifestations of rotavirus infection in children

Jackson, Charlotte; Bryant, Penelope A

doi:10.1136/bcr.04.2011.4134

Cited by 3 publications

(4 citation statements)

References 6 publications

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“…Our results support previous studies linking rotavirus-induced autoimmunity to arthritis, vasculitis, and neurologic diseases . Previous studies indicated that rotavirus infection could potentially trigger autoimmunity in immune-privileged sites, including the intestine, pancreas, brain, kidney, and lymph nodes .…”

Section: Discussionsupporting

confidence: 92%

“…Our results support previous studies linking rotavirus-induced autoimmunity to arthritis, vasculitis, and neurologic diseases. 31 , 32 Previous studies indicated that rotavirus infection could potentially trigger autoimmunity in immune-privileged sites, 2 including the intestine, 3 , 6 pancreas, 12 , 33 brain, 12 , 13 , 14 , 26 , 32 kidney, 30 and lymph nodes. 29 , 34 Furthermore, animal studies demonstrated that rotavirus can penetrate host cells and replicate in nonenterocytes, possibly evading immune responses and systemic sequelae, 35 indicating potential associations with conditions like type 1 diabetes, 36 vasculitis, 37 and neurologic disorders.…”

Section: Discussionmentioning

confidence: 99%

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Rotavirus-Associated Hospitalization in Children With Subsequent Autoimmune Disease

Kim

Ryeong

et al. 2023

JAMA Netw Open

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ImportanceRotavirus infection is a common cause of gastroenteritis in children that can trigger autoimmune processes, but the nature of this interaction remains poorly understood.ObjectiveTo estimate the association of rotavirus infection with the risk of subsequent autoimmune disease.Design, Setting, and ParticipantsThis population-matched cohort study used data from children and adolescents (aged younger than 18 years) in South Korea (national registers from January 1, 2002, to December 31, 2017). The cohort consisted of 86 157 patients in the exposure group who had experienced rotavirus-associated hospitalization and the same number of matched patients in the unexposed group. Data analyses were from May 1, 2020, through October 20, 2022.ExposuresHospitalization for rotavirus infection.Main Outcomes and MeasuresThe main outcome was childhood autoimmune diseases during the study defined by diagnoses according to the National Health Insurance Database. Hazard ratios (HRs) with 95% CIs for autoimmune diseases were estimated using a Cox model, with multiple confounding factors controlled.ResultsThis cohort study consisted of 1 914 461 individuals born in South Korea from 2002 to 2005 who were potentially eligible. After exclusions, there were 86 517 individuals in the exposed group and 86 517 in the unexposed group after 1:1 incidence density sampling. The study included 49 072 (57.0%) male patients. The median (IQR) age at diagnosis of rotavirus-associated hospitalization was 1.5 (0.9-2.7) years, and the HR for autoimmune disease in the exposed group was 1.24 (95% CI, 1.19-1.28) for a mean (SD) follow-up time of 12.1 (3.2) years. The use of more stringent definitions for exposure and outcomes in a multivariable stratified analysis also indicated that rotavirus-associated hospitalization was associated with an increased risk of subsequent autoimmune disease (HR, 1.22 [95% CI, 1.16-1.28]). Sensitivity analysis showed that individuals with rotavirus-associated hospitalization was related to multiple autoimmune syndromes (2 or more: HR, 1. 51 [95% CI, 1. 31-1. 73]; 3 or more: HR, 1. 79 [95% CI, 1.18-2.72]) and that the number of rotavirus-associated hospitalization were associated with higher risks for autoimmune disease in a dose-dependent manner (single hospitalization event: HR, 1.20 [95% CI, 1.16-1.24]; multiple events HR, 1.60 [95% CI, 1.49-1.72]).Conclusions and RelevanceOur results indicate that rotavirus-associated hospitalization is significantly associated with subsequent autoimmune disease during childhood. Clinicians should be aware of the heightened susceptibility to autoimmune disease in individuals with prior rotavirus-associated hospitalization.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Rotavirus-Associated Hospitalization in Children With Subsequent Autoimmune Disease

Kim

Ryeong

et al. 2023

JAMA Netw Open

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“…The analysis of the literature revealed 794 publications, 83 of which were included in this systematic review (Figure 1). Out of these, 68 permitted a detailed analysis of cases 4–8,11,17–78 while 15 publications, dealing with CwG and rotavirus infection, only reported prevalence and therefore did not allow a detailed analysis 10,48,79–91 . Although these latter 15 publications were not included in the systematic analysis, they were used to calculate the prevalence of CwG in rotavirus infection or the prevalence of rotavirus infection in patients with CwG (Figure 1).…”

Section: Resultsmentioning

confidence: 99%

Neurological complications of rotavirus infection in children: A systematic review and meta‐analysis

et al. 2023

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Rotavirus is a common cause of benign, self-limiting gastroenteritis in childhood. 1,2 Apart from dehydration and electrolyte imbalance, several neurological complications have been described in rotavirus infections in recent years, such as encephalitis, cerebellitis and a condition described as benign convulsions with mild gastroenteritis (CwG). [3][4][5][6] A direct viral pathomechanism has been postulated since the virus was first detected in the cerebrospinal fluid of a patient suffering from encephalitis in 1995 4 and in subsequent reports. 6,7 CwG was first described in 1982 by Morooka et al. in patients who presented with convulsions associated with mild gastroenteritis without fever or laboratory abnormalities. 3 The definition of CwG was further elaborated in 1992 by Komori et al. as convulsions in

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“…Although affection of the central nervous system is not common in children with rotavirus diarrhea, it occurred in two our patients. First to report association of this disease with rotavirus diarrhea were Day and coauthors ( 23 ). They reported neurological symptoms and stool virology positive for rotavirus in four children, presented within 4 weeks in Barnet and Chase Farm Hospitals NHS Trust, London, UK.…”

Section: Discussionmentioning

confidence: 99%

Characteristics of Rotavirus Diarrhea in Hospitalized Children in Kosovo

Ismaili-Jaha¹,

Shala²,

Azemi³

et al. 2014

Mater Sociomed

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Background:Diarrhea is a leading cause of child mortality worldwide. Rotavirus is one of the most common causes of severe diarrhea and dehydration in children. Authors reviewed epidemiological and clinical data of the rotavirus diarrhea in Kosovo.Methods:This is a prospective study carried between January 1st and December 31st 2011. All data, comprising demographics, nutrition, clinical presentation, laboratory findings, management and outcome of the rotavirus diarrhea are collected on the specially designed form.Results:116 children with rotavirus diarrhea are included in the study. The majority boys (74.4%) and children aged 0 – 12 months (82.75%). Mean age of children in the study was 16.38 months. Almost every third child in the study was hypotrophic (29.2%). More than half of the infants (55.2%) were on mixed food, somewhat more than every third was breast feeding (36.45%), and every twelfth (8.33%) was on artificial milk (animal or formula). Apart from diarrhea, present in all patients, vomiting (97.41%) and fever (43.96%) were characteristics of the clinical presentation of the diarrhea. Two thirds of the children had mild grade dehydration (70.7%). All patients recovered with no sequels.Conclusion:Rotavirus continues to be responsible for a significant portion of acute diarrhea in Kosovo. Clinical features, epidemiological data and the agglutination test are safe enough to establish the diagnosis. Treated correctly rotavirus diarrhea has a favorable outcome.

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Cluster of neurological manifestations of rotavirus infection in children

Cited by 3 publications

References 6 publications

Rotavirus-Associated Hospitalization in Children With Subsequent Autoimmune Disease

Rotavirus-Associated Hospitalization in Children With Subsequent Autoimmune Disease

Neurological complications of rotavirus infection in children: A systematic review and meta‐analysis

Characteristics of Rotavirus Diarrhea in Hospitalized Children in Kosovo

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