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Characteristics and outcomes of patients diagnosed with norovirus gastroenteritis after allogeneic hematopoietic stem cell transplantation based on immunochromatography

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Abstract

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.

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Acknowledgments

The authors thank Ms. Mariko Ohnishi for immunochromatographic analysis and clinical research assistance. This work was supported by grants from the Japanese Ministry of Health, Labour and Welfare and the Advanced Clinical Research Organization. Some of these results were presented at the 38th Annual Meeting of the European Group for Blood and Marrow Transplantation in Geneva, Switzerland, April 2, 2012.

Conflict of interest

The authors declare no conflicts of interest.

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Authors and Affiliations

  1. Hematopoietic Stem Cell Transplantation Division, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan

    Ryosuke Ueda, Shigeo Fuji, Nobuhiro Hiramoto, Hisayoshi Hashimoto, Takashi Tanaka, Kohei Tada, Yujin Kobayashi, Noriyuki Morikawa, Akihito Shinohara, Keiji Okinaka, Saiko Kurosawa, Sung-Won Kim, Takuya Yamashita & Takahiro Fukuda

  2. Department of Hemato-Oncology, St. Luke’s International Hospital, Tokyo, Japan

    Shin-ichiro Mori

  3. Pathology and Clinical Laboratory Division, National Cancer Center Hospital, Tokyo, Japan

    Akiko M. Maeshima

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  1. Ryosuke Ueda
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  2. Shigeo Fuji
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Correspondence to Shigeo Fuji.

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Ueda, R., Fuji, S., Mori, Si. et al. Characteristics and outcomes of patients diagnosed with norovirus gastroenteritis after allogeneic hematopoietic stem cell transplantation based on immunochromatography. Int J Hematol 102, 121–128 (2015). https://doi.org/10.1007/s12185-015-1804-2

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  • DOI: https://doi.org/10.1007/s12185-015-1804-2

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