Characteristics and outcomes of patients diagnosed with norovirus gastroenteritis after allogeneic hematopoietic stem cell transplantation based on immunochromatography.
Norovirus gastroenteritis (NV-GE) is a highly transmittable disease that can lead to fatal outcomes in vulnerable populations including patients after hematopoietic stem cell transplantation (HSCT). Prompt detection of NV is therefore important for HSCT recipients. Immunochromatography (IC) can be used to easily and rapidly diagnose NV-GE by detecting NV antigens. In this study, we examined 642 stool specimens in patients who developed diarrhea after allogeneic HSCT between January 2007 and June 2011. NV was detected in 10 of 350 (2.9 %) HSCT recipients. The median onset of symptoms was 36 days (range 3-93) after HSCT. The median duration of symptoms was 42 days (3-135). A second or subsequent allogeneic HSCT was associated with a higher incidence of NV-GE (P = 0.034). Of four patients who underwent colonoscopy, two showed intestinal graft-versus-host disease (GVHD) histopathology, whereas the other two showed no evidence of GVHD, and thus no need for intensified immunosuppression. None of the patients died of NV-GE. In conclusion, IC may be useful in the differential diagnosis of diarrhea after allogeneic HSCT, and could enable the appropriate adjustment of immunosuppressive drugs and prompt preventive measures.
Hematopoietic Stem Cell Transplantation Division, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan.
Ryosuke
R
Ueda
Shigeo
S
Fuji
Shin-ichiro
S
Mori
Nobuhiro
N
Hiramoto
Hisayoshi
H
Hashimoto
Takashi
T
Tanaka
Kohei
K
Tada
Yujin
Y
Kobayashi
Noriyuki
N
Morikawa
Akihito
A
Shinohara
Keiji
K
Okinaka
Akiko M
AM
Maeshima
Saiko
S
Kurosawa
Sung-Won
SW
Kim
Takuya
T
Yamashita
Takahiro
T
Fukuda
D000328:Adult; D000368:Aged; D000956:Antigens, Viral / Q000276:immunology; D017250:Caliciviridae Infections / Q000175:diagnosis* / Q000453:epidemiology / Q000276:immunology* / Q000517:prevention & control; D002423:Cause of Death; D002846:Chromatography, Affinity / Q000379:methods; D005260:Female; D005759:Gastroenteritis / Q000175:diagnosis* / Q000453:epidemiology / Q000276:immunology* / Q000517:prevention & control; D006086:Graft vs Host Disease / Q000209:etiology / Q000517:prevention & control; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D029322:Norovirus / Q000276:immunology*; D063868:Patient Outcome Assessment; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D014184:Transplantation, Homologous; D055815:Young Adult
D000956:Antigens, Viral