TY - JOUR
T1 - Fulminant adenovirus hepatitis after hematopoietic stem cell transplant
T2 - Retrospective real-time PCR analysis for adenovirus DNA in two cases
AU - Kawashima, Nozomu
AU - Muramatsu, Hideki
AU - Okuno, Yusuke
AU - Torii, Yuka
AU - Kawada, Jun ichi
AU - Narita, Atsushi
AU - Nakanishi, Koji
AU - Hama, Asahito
AU - Kitamura, Aya
AU - Asai, Naoya
AU - Nakamura, Shigeo
AU - Takahashi, Yoshiyuki
AU - Ito, Yoshinori
AU - Kojima, Seiji
N1 - Publisher Copyright:
© 2015 Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases.
PY - 2015/12/1
Y1 - 2015/12/1
N2 - Background: Viral infection is one of the major causes of mortality in patients undergoing hematopoietic stem cell transplant (HSCT). Systemic infection of adenovirus (AdV) has emerged as a not uncommon viral infection with significant morbidity and mortality as with cytomegalovirus and Epstein-Barr virus infection. Routine surveillance for these viruses has become a clinical practice and subsequent preemptive therapy improves patients' outcomes; however, the effectiveness of preemptive therapy for AdV has not been fully investigated in patients with a lethal form of AdV infection. Methods: Sequential AdV loads were retrospectively analyzed in children with fulminant AdV hepatitis after HSCT. Results: The AdV DNA became detectable (1 × 104 copies/mL) as early as 2 weeks after HSCT. These levels reached >1 × 108 copies/mL at the onset of fulminant hepatitis. However, we determined that γ-glutamyltransferase levels were elevated to >100 IU/L at least 2 weeks before the diagnosis of hepatitis. Conclusions: Our observation raises the possibility that elevated γ-glutamyltransferase could be a sentinel marker for AdV hepatitis, which prompts elaborated monitoring of AdV load and targeted treatment.
AB - Background: Viral infection is one of the major causes of mortality in patients undergoing hematopoietic stem cell transplant (HSCT). Systemic infection of adenovirus (AdV) has emerged as a not uncommon viral infection with significant morbidity and mortality as with cytomegalovirus and Epstein-Barr virus infection. Routine surveillance for these viruses has become a clinical practice and subsequent preemptive therapy improves patients' outcomes; however, the effectiveness of preemptive therapy for AdV has not been fully investigated in patients with a lethal form of AdV infection. Methods: Sequential AdV loads were retrospectively analyzed in children with fulminant AdV hepatitis after HSCT. Results: The AdV DNA became detectable (1 × 104 copies/mL) as early as 2 weeks after HSCT. These levels reached >1 × 108 copies/mL at the onset of fulminant hepatitis. However, we determined that γ-glutamyltransferase levels were elevated to >100 IU/L at least 2 weeks before the diagnosis of hepatitis. Conclusions: Our observation raises the possibility that elevated γ-glutamyltransferase could be a sentinel marker for AdV hepatitis, which prompts elaborated monitoring of AdV load and targeted treatment.
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U2 - 10.1016/j.jiac.2015.08.018
DO - 10.1016/j.jiac.2015.08.018
M3 - Article
C2 - 26423689
AN - SCOPUS:84947493743
SN - 1341-321X
VL - 21
SP - 857
EP - 863
JO - Journal of Infection and Chemotherapy
JF - Journal of Infection and Chemotherapy
IS - 12
ER -