الفهرس 
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Abstract
Summary
Norovirus is one of the most common viral agents causing acute gastroenteritis in children. With rotavirus vaccines being introduced and widely used, norovirus infection start to grow and gain attention. These findings suggest that norovirus is a more important viral agent than other enteric viruses.
Interleukin-8 (IL-8), a member of the chemotactic cytokine family, plays an important role in recruiting inflammatory cells such as neutrophils and lymphocytes to an inflammatory site. Previous studies on IL-6 and IL-8 in the pathogenesis of gastroenteritis have mainly focused on rotavirus and bacterial infections.
This study was conducted at Beni-Suef University Hospital to evaluate the role of interleukin-8 in patients with norovirus gastroenteritis.
According to the socio-demographic data of the patients, this study showed that there was no significant difference between cases in all groups regarding their age, sex and residence. The mean age for positive cases of norovirus was 12.3±8.7 years, most of them were males (62.1 %) and those living in rural areas was 91.4 % of cases .
Regarding the course of the disease, 69 % of positive cases of norovirus showed a regressive course and the mean duration of the disease was 3.1±1.2 days.
Also for the disease prognosis,.there was a significant association of improvement in GE with norovirus .Of the 116 positive cases of norovirus 78 cases (67.2%) improved, and 38 cases (32.8%) not improved (P-value<0.05).
According to disease characteritics,patients usually present with diarrhea which may be associated with fever, vomiting and abdominal cramps. For positive cases of norovirus, fever was recorded in 112 cases representing 96.6 % of patients, about 70 patients (60.3 %) of cases complained from abdominal cramps and all patients had vomiting.Also,there was a significant association of fever, abdominal cramps, and vomiting with positive cases of norovirus (P-value<0.05).
Also.the degree of dehydration was assessed using the Vesikari modified severity score that showed a score of 9.4±1.3 for positive cases of norovirus versus 8.4±2 for negative cases of norovirus. According to the degree of dehydration, 69 % of positive cases of norovirus had moderate dehydration and 27.6 % had mild dehydration. Only 3.4 % of positive cases of norovirus had severe dehydration(P-value<0.05).
As regards the systemic manifestations of norovirus, 12.1 % of positive cases of norovirus had chest symptomsand theneurological and cardiac symptoms were recorded in 3.4 % of patients for each.
According to laboratory investigations,there was no significant difference between positive and negative cases of norovirus regarding the platelets level, TLC and CRP levels(P-value>0.05). The mean platelet level was 281.1±89.5, the mean TLC count was 8.9±1.5 and CRP reached 6±2.9.Also,regarding the TLC and CRP, they were significantly higher in positive and negative cases than control (p-value<0.001). Regarding the hemoglobin level, it was significantly higher in control group than positive and negative cases of norovirus (p-value=0.007).
Also,there was no significant difference between positive and negative cases of norovirus regarding the serum sodium and potassium. The mean serum sodium level for positive cases of norovirus was 141.3±3.6 and the mean potassium level was 4.4±0.6 (P-value>0.05).
Finally according to the results of this study,the serum IL-8 had a significant role in prediction and differentiation of gatstroenteritis between positive and negative cases of norovirus with variable degrees of sensitivity and specificity.
Alsothe serum level of IL-8 in children with viral gastroenteritis had been estimated it was higher than that of healthy control group.
.As regards to IL-8 level,the mean level for positive cases of norovirus was 172.8±56.4 and for negative cases of norovirus was 139±45.3. For healthy control cases the mean level was 36.3±15.6.So, there was a significant difference between positive and negative cases of norovirus and healthy controls (P-value<0.001).
Also,regarding to sensitivity and specificity tests ,at a cut off more than or equal 71.1, IL-8 can predict the GE (vs control) with 97.1% sensitivity and 100% specificity. At a cut off more than or equal 71.1, IL-8 can predict the negative cases of norovirus (vs control) with 100% sensitivity and 100% specificity. At a cut off more than or equal 71.6, IL-8 can predict thepositive cases of norovirus (vs control) with 96.6% sensitivity and 100% specificity. At a cut off more than or equal 26.9, IL-8 can predict the positive cases (vs the negative cases of norovirus GE) with 81% sensitivity and 53% specificity (p-value<0.001).