Allogeneic Hematopoietic Stem Cell Transplantation and Norovirus Gastroenteritis: A Previously Unrecognized Cause of Morbidity

摘要: Background. A retrospective study of the clinical, epidemiologic, and virologic features norovirus gastroenteritis in 12 adult allogeneic hematopoietic stem cell transplant (HSCT) recipients.Methods. Norovirus infection was diagnosed by reverse-transcriptase polymerase chain reaction. Strains were genotyped nucleic acid sequence most highly conserved region gene encoding capsid S (shell) domain.Results. Ten patients presented with vomiting short duration, but diarrhea present all. The median time from onset to diagnosis 1 month (range, 0.25-6.0 months). Eleven receiving immunosuppression when diagnosed: 8 for graft-versus-host disease (GVHD) an organ other than gut, previous gut GVHD, 2 presumed GVHD that proved be gastroenteritis. Six required enteral or parenteral nutrition severe weight loss. In 10 patients, lasted a 3 months 0.5-14 months) virus shed at high level throughout. remaining died after 4 (one unrelated complications, malnutrition). noroviruses found GII (untyped), GII-3, GII-4, GII-7 1, 9, respectively. had acquired their community. Phylogenetic analysis GII-4 strains demonstrated all differed.Conclusions. Noroviruses are hitherto unsuspected cause prolonged morbidity mortality adults HSCT. use reaction detect viral load levels feces distinguishes GVHD.