Is there a role for oral human immunoglobulin in the treatment for norovirus enteritis in immunocompromised patients?

Diana F Florescu, Elizabeth D. Hermsen, Joong Y. Kwon, Dalal Gumeel, Wendy J. Grant, David F Mercer, Andre C Kalil

Research output: Contribution to journalArticle

44 Citations (Scopus)

Abstract

No treatment for NVE is available. Immunocompromised patients with NVE treated with OHIG (12 cases) were retrospectively identified and matched 1:1 by age and gender with immunocompromised patients with NVE not treated with OHIG (12 controls). Chi-squared test, t-test, bivariate conditional linear regression analyses, and Kaplan-Meier curve were performed. A total of 58.3% patients were small bowel transplant (SBT) recipients. Although not statistically significant, cases compared with controls were more likely to have had induction therapy (p = 0.25, OR = 65.3), higher peak tacrolimus levels (p = 0.43, OR = 1.04), SBT (p = 0.30, OR = 65.3), prior NVE (p = 0.42, OR = 2.0), TPN support (p = 0.42 OR = 2.0), and decrease in immunosuppression (p = 0.14, OR = 5.0). Treatment with OHIG favored resolution of diarrhea (p = 0.078, OR = 65.3) and decreased stool output seven days after treatment compared with controls (mean difference 11.95 mL/kg/day, p = 0.09). OHIG did not impact total time to resolution of diarrhea (mean 12.08 vs. 11.91 days; p = 0.63), length of hospital stay (p = 0.31, OR = 1.05), or cost of hospitalization (p = 0.32, OR = 1.0). We show a potential role of OHIG treatment for NVE. Resolution of diarrhea and decreased stool output were observed at seven days; no benefit was found for length of hospital stay or hospital cost.

Original languageEnglish (US)
Pages (from-to)718-721
Number of pages4
JournalPediatric Transplantation
Volume15
Issue number7
DOIs
StatePublished - Nov 1 2011

Fingerprint

Norovirus
Enteritis
Immunocompromised Host
Immunoglobulins
Length of Stay
Diarrhea
Therapeutics
Hospital Costs
Tacrolimus
Immunosuppression
Linear Models
Hospitalization
Regression Analysis
Transplants
Costs and Cost Analysis

Keywords

  • immunocompromised
  • immunoglobulin
  • norovirus enteritis

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Transplantation

Cite this

Is there a role for oral human immunoglobulin in the treatment for norovirus enteritis in immunocompromised patients? / Florescu, Diana F; Hermsen, Elizabeth D.; Kwon, Joong Y.; Gumeel, Dalal; Grant, Wendy J.; Mercer, David F; Kalil, Andre C.

In: Pediatric Transplantation, Vol. 15, No. 7, 01.11.2011, p. 718-721.

Research output: Contribution to journalArticle

@article{3582fc7bbae240c7becef68fa9cbc341,
title = "Is there a role for oral human immunoglobulin in the treatment for norovirus enteritis in immunocompromised patients?",
abstract = "No treatment for NVE is available. Immunocompromised patients with NVE treated with OHIG (12 cases) were retrospectively identified and matched 1:1 by age and gender with immunocompromised patients with NVE not treated with OHIG (12 controls). Chi-squared test, t-test, bivariate conditional linear regression analyses, and Kaplan-Meier curve were performed. A total of 58.3{\%} patients were small bowel transplant (SBT) recipients. Although not statistically significant, cases compared with controls were more likely to have had induction therapy (p = 0.25, OR = 65.3), higher peak tacrolimus levels (p = 0.43, OR = 1.04), SBT (p = 0.30, OR = 65.3), prior NVE (p = 0.42, OR = 2.0), TPN support (p = 0.42 OR = 2.0), and decrease in immunosuppression (p = 0.14, OR = 5.0). Treatment with OHIG favored resolution of diarrhea (p = 0.078, OR = 65.3) and decreased stool output seven days after treatment compared with controls (mean difference 11.95 mL/kg/day, p = 0.09). OHIG did not impact total time to resolution of diarrhea (mean 12.08 vs. 11.91 days; p = 0.63), length of hospital stay (p = 0.31, OR = 1.05), or cost of hospitalization (p = 0.32, OR = 1.0). We show a potential role of OHIG treatment for NVE. Resolution of diarrhea and decreased stool output were observed at seven days; no benefit was found for length of hospital stay or hospital cost.",
keywords = "immunocompromised, immunoglobulin, norovirus enteritis",
author = "Florescu, {Diana F} and Hermsen, {Elizabeth D.} and Kwon, {Joong Y.} and Dalal Gumeel and Grant, {Wendy J.} and Mercer, {David F} and Kalil, {Andre C}",
year = "2011",
month = "11",
day = "1",
doi = "10.1111/j.1399-3046.2011.01556.x",
language = "English (US)",
volume = "15",
pages = "718--721",
journal = "Pediatric Transplantation",
issn = "1397-3142",
publisher = "Wiley-Blackwell",
number = "7",

}

TY - JOUR

T1 - Is there a role for oral human immunoglobulin in the treatment for norovirus enteritis in immunocompromised patients?

AU - Florescu, Diana F

AU - Hermsen, Elizabeth D.

AU - Kwon, Joong Y.

AU - Gumeel, Dalal

AU - Grant, Wendy J.

AU - Mercer, David F

AU - Kalil, Andre C

PY - 2011/11/1

Y1 - 2011/11/1

N2 - No treatment for NVE is available. Immunocompromised patients with NVE treated with OHIG (12 cases) were retrospectively identified and matched 1:1 by age and gender with immunocompromised patients with NVE not treated with OHIG (12 controls). Chi-squared test, t-test, bivariate conditional linear regression analyses, and Kaplan-Meier curve were performed. A total of 58.3% patients were small bowel transplant (SBT) recipients. Although not statistically significant, cases compared with controls were more likely to have had induction therapy (p = 0.25, OR = 65.3), higher peak tacrolimus levels (p = 0.43, OR = 1.04), SBT (p = 0.30, OR = 65.3), prior NVE (p = 0.42, OR = 2.0), TPN support (p = 0.42 OR = 2.0), and decrease in immunosuppression (p = 0.14, OR = 5.0). Treatment with OHIG favored resolution of diarrhea (p = 0.078, OR = 65.3) and decreased stool output seven days after treatment compared with controls (mean difference 11.95 mL/kg/day, p = 0.09). OHIG did not impact total time to resolution of diarrhea (mean 12.08 vs. 11.91 days; p = 0.63), length of hospital stay (p = 0.31, OR = 1.05), or cost of hospitalization (p = 0.32, OR = 1.0). We show a potential role of OHIG treatment for NVE. Resolution of diarrhea and decreased stool output were observed at seven days; no benefit was found for length of hospital stay or hospital cost.

AB - No treatment for NVE is available. Immunocompromised patients with NVE treated with OHIG (12 cases) were retrospectively identified and matched 1:1 by age and gender with immunocompromised patients with NVE not treated with OHIG (12 controls). Chi-squared test, t-test, bivariate conditional linear regression analyses, and Kaplan-Meier curve were performed. A total of 58.3% patients were small bowel transplant (SBT) recipients. Although not statistically significant, cases compared with controls were more likely to have had induction therapy (p = 0.25, OR = 65.3), higher peak tacrolimus levels (p = 0.43, OR = 1.04), SBT (p = 0.30, OR = 65.3), prior NVE (p = 0.42, OR = 2.0), TPN support (p = 0.42 OR = 2.0), and decrease in immunosuppression (p = 0.14, OR = 5.0). Treatment with OHIG favored resolution of diarrhea (p = 0.078, OR = 65.3) and decreased stool output seven days after treatment compared with controls (mean difference 11.95 mL/kg/day, p = 0.09). OHIG did not impact total time to resolution of diarrhea (mean 12.08 vs. 11.91 days; p = 0.63), length of hospital stay (p = 0.31, OR = 1.05), or cost of hospitalization (p = 0.32, OR = 1.0). We show a potential role of OHIG treatment for NVE. Resolution of diarrhea and decreased stool output were observed at seven days; no benefit was found for length of hospital stay or hospital cost.

KW - immunocompromised

KW - immunoglobulin

KW - norovirus enteritis

UR - http://www.scopus.com/inward/record.url?scp=80054993006&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=80054993006&partnerID=8YFLogxK

U2 - 10.1111/j.1399-3046.2011.01556.x

DO - 10.1111/j.1399-3046.2011.01556.x

M3 - Article

VL - 15

SP - 718

EP - 721

JO - Pediatric Transplantation

JF - Pediatric Transplantation

SN - 1397-3142

IS - 7

ER -