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Severity and outcome of the norovirus infection in children after intestinal transplantation
Author(s) -
Patte Marie,
Canioni Danielle,
Fenoel Véronique Avettand,
Frange Pierre,
Rabant Marion,
Talbotec Cécile,
Lacaille Florence
Publication year - 2017
Publication title -
pediatric transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.457
H-Index - 69
eISSN - 1399-3046
pISSN - 1397-3142
DOI - 10.1111/petr.12930
Subject(s) - medicine , norovirus , diarrhea , viral shedding , gastroenterology , transplantation , pathological , feces , surgery , immunology , virus , paleontology , biology
In immunocompromised patients, the NoV infection is prolonged and severe. We retrospectively studied the severity of the NoV infection in children after an ITx , the treatment, and the long‐term evolution. Norovirus PCR in stools was positive for 19 children in 21 separate episodes. The infection was symptomatic in 18 cases. At diagnosis, the median weight loss was 5% (0‐11) and the creatinine clearance was 75 mL/min/1.73 m 2 (19‐142). On 14 digestive biopsies, the pathological findings were non‐specific with a constant mononuclear infiltration, showing signs of rejection in one case. Fifteen children in 17 cases were hospitalized for a median duration of 41 days (0‐119) with IV infusions for 33 days (0‐120). The viral shedding lasted 78 days (20‐360). Nine children with severe or prolonged diarrhea received intravenous IGs and four of them additional NTZ . On follow‐up, five other children developed a rejection 12 months (1‐33) after NoV infection. Four uncontrolled rejections led to graft removal. Children mostly needed hospital admission and IV rehydration, but the symptoms upon presentation were moderate. Symptoms and shedding durations are prolonged as expected. The treatment efficacy cannot be assessed. The rejection induction by the NoV cannot be excluded.