title: Norovirus-related chronic diarrhea in a patient treated with alemtuzumab for chronic lymphocytic leukemia.
abstract: BACKGROUND
  Norovirus infection is increasingly recognized as an important cause of persistent gastroenteritis in immunocompromised hosts and can be a potential cause of morbidity in these populations.
  
  
  METHODS
  Here, we report a case of norovirus-related chronic diarrhea occurring in a 62-year-old immunocompromised patient treated with alemtuzumab for chronic lymphocytic leukemia. Despite different therapeutic strategies including tapering of immunosuppressive therapy and immunoglobulin administration, diarrhea unfortunately did not resolve and lasted for a total of more than twelve weeks with prolonged norovirus fecal excretion.
  
  
  CONCLUSIONS
  Norovirus infection can occur in the setting of alemtuzumab treatment, even as a single agent, and should be included in the differential diagnoses of acute and chronic diarrhea in these immunocompromised patients. Although the administration of oral immunoglobulin has been described as a promising efficient therapy, this was not the case in our patient. Clinical trials are thus clearly warranted to better define risk factors and efficient therapies for norovirus infection in immunocompromised populations.
authors.forename: Anne-Marie
authors.initials: AM
authors.lastname: Ronchetti
authors.forename: Benoit
authors.initials: B
authors.lastname: Henry
authors.forename: Katia
authors.initials: K
authors.lastname: Ambert-Balay
authors.forename: Pierre
authors.initials: P
authors.lastname: Pothier
authors.forename: Justine
authors.initials: J
authors.lastname: Decroocq
authors.forename: Véronique
authors.initials: V
authors.lastname: Leblond
authors.affiliation: Hematology Department, Hôpital Pitié-Salpétrière, AP-HP, Université Pierre et Marie Curie Paris 06, GRC 11 (GRECHY), Paris, France. damien.roos-weil@inserm.fr.
authors.forename: Damien
authors.initials: D
authors.lastname: Roos-Weil
mesh_terms: D000074323:Alemtuzumab; D061067:Antibodies, Monoclonal, Humanized / Q000009:adverse effects*; D017250:Caliciviridae Infections / Q000139:chemically induced / Q000175:diagnosis / Q000821:virology*; D002908:Chronic Disease; D003967:Diarrhea / Q000139:chemically induced / Q000821:virology*; D005759:Gastroenteritis / Q000139:chemically induced / Q000821:virology*; D006801:Humans; D016867:Immunocompromised Host; D015451:Leukemia, Lymphocytic, Chronic, B-Cell / Q000150:complications / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D029322:Norovirus / Q000302:isolation & purification*
chemical_list: D061067:Antibodies, Monoclonal, Humanized; D000074323:Alemtuzumab