Clinical Usefulness of Oral Immunoglobulins in Lung Transplant Recipients With Norovirus Gastroenteritis: A Case Series

Gairard-Dory, A.; Degot, T.; Hirschi, Sandrine; Schüller, Arthur; Leclercq, Alexandre; Renaud-Picard, B.; Gourieux, B.; Kessler, Romain

doi:10.1016/j.transproceed.2014.09.095

Cited by 35 publications

(35 citation statements)

References 20 publications

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“…This is consistent with other small studies: Oral IgG has been a successful therapy for chronic diarrhea in two children with primary immunodeficiency, six stem cell recipients with rotavirus‐associated diarrhea . Favorable effect of oral IgG on diarrhea has also been described in adult, but not in pediatric, small bowel, lung, and kidney transplant recipients . A retrospective study of 12 lung transplant recipients with norovirus‐associated diarrhea found complete symptom resolution in 11 patients .…”

Section: Discussionsupporting

confidence: 89%

“…A prospective study of 98 children with rotavirus gastroenteritis found no recurrence after IgG treatment . Similarly, no recurrence was noted in 7 of the 11 lung transplant recipients treated with oral IgG for diarrhea . Unlike our findings, Melamed et al noted diarrhea recurrence in both patients with primary immunodeficiency after discontinuing oral IgG.…”

Section: Discussioncontrasting

confidence: 76%

“…Duration reported in the literature ranges from a single dose to several months of treatment . The cumulative dose in our patients ranged from 50 to 1500 mg/kg while the doses reported in the literature for transplant recipients range from 200 to 1400 mg/kg . Guarino et al published one of the earlier studies on the use of oral IgG for rotavirus and used the dose of 300 mg/kg.…”

Section: Discussionmentioning

confidence: 85%

“…Favorable effect of oral IgG on diarrhea has also been described in adult, but not in pediatric, small bowel, lung, and kidney transplant recipients . A retrospective study of 12 lung transplant recipients with norovirus‐associated diarrhea found complete symptom resolution in 11 patients . Similarly, cryptosporidium and norovirus‐associated diarrhea in 2 kidney transplant recipients improved after treatment with oral IgG …”

Section: Discussionmentioning

confidence: 99%

“…oral IgG is considered effective in preventing rotavirus‐associated gastroenteritis in low‐birthweight infants and shortens the duration of acute gastroenteritis in hospitalized children . Oral IgG may also be effective in ameliorating rotavirus‐ and norovirus‐associated diarrhea in adult stem cell and solid organ recipients . Oral IgG has not been studied in pediatric solid organ transplant recipients.…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Use of oral immunoglobulins to treat diarrhea in pediatric kidney transplant recipients—Single‐center experience and review of the literature

Kizilbash

Sudel

Anderson

et al. 2019

Pediatric Transplantation

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Effective treatment modalities for diarrhea in solid organ transplant recipients are lacking. We evaluated the effect of oral IgG on clinical course of diarrhea in pediatric kidney transplant recipients. We retrospectively studied all pediatric kidney transplant recipients who required hospitalization for diarrhea between January 1, 2015, and December 31, 2017. We divided the recipients into two groups based on whether they had received oral IgG to treat diarrhea. Sixteen pediatric kidney transplant recipients required hospitalization for diarrhea over 3 years. Median age at admission was 9.25 years (IQR:12.54). Fifty‐six percent of recipients were male, and 81% were white. Four patients received oral IgG for prolonged diarrhea. Oral IgG recipients had longer diarrheal duration before admission (median (days) 14.5 vs1; P .02), a trend for greater weight loss at admission (median (kilogram) 1.4 vs 0.2; P .3), and a trend for higher acute kidney injury (>75% reduction in glomerular filtration rate: 100% vs 42%; P .36). Diarrhea resolved completely in 3 (75%) oral IgG recipients and 7 (58%) non‐oral IgG patients by discharge (P .99). One oral IgG recipient showed partial improvement but also had biopsy evidence of mycophenolate‐induced colitis. All patients tolerated oral IgG well. No patients required re‐hospitalization within 30 days of discharge. Oral IgG may be used safely and effectively to treat prolonged diarrhea in pediatric kidney transplant recipients. A larger, randomized, prospective study is needed to further assess the efficacy of oral IgG in the treatment of diarrhea.

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Section: Discussionsupporting

confidence: 89%

Section: Discussioncontrasting

confidence: 76%

Section: Discussionmentioning

confidence: 85%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Use of oral immunoglobulins to treat diarrhea in pediatric kidney transplant recipients—Single‐center experience and review of the literature

Kizilbash

Sudel

Anderson

et al. 2019

Pediatric Transplantation

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Antiviral Targets and Strategies to Treat and Prevent Human Norovirus Infections

Dycke

Cuvry

Neyts

et al. 2021

New Drug Development for Known and Emerging Viruses

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Severe allograft rejection in an intestinal transplant patient following oral immunoglobulin treatment for chronic norovirus infection: a case report

Åberg

Savikko

Anttila

et al. 2018

Clinical Case Reports

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Key Clinical MessageIn an intestinal transplant patient under triple immunosuppression therapy with tacrolimus levels >10 ng/L, a 2‐day oral immunoglobulin therapy given as treatment for chronic norovirus infection was temporally closely associated with the development of severe steroid‐resistant acute graft rejection, thus suggesting that oral immunoglobulin might be able to promote a rejection response.

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Clinical Usefulness of Oral Immunoglobulins in Lung Transplant Recipients With Norovirus Gastroenteritis: A Case Series

Cited by 35 publications

References 20 publications

Use of oral immunoglobulins to treat diarrhea in pediatric kidney transplant recipients—Single‐center experience and review of the literature

Use of oral immunoglobulins to treat diarrhea in pediatric kidney transplant recipients—Single‐center experience and review of the literature

Antiviral Targets and Strategies to Treat and Prevent Human Norovirus Infections

Severe allograft rejection in an intestinal transplant patient following oral immunoglobulin treatment for chronic norovirus infection: a case report

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