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Chronic norovirus infection in primary immune deficiency disorders: an international case series

Rolfes, M.C., Sriaroon, P., Dávila Saldaña, B.J., Dvorak, C.C., Chapdelaine, H., Ferdman, R.M., Chen, K., Jolles, S., Patel, N.C., Kim, Y.J., Tarrant, T.K., Martelius, T, Seppanen, M. and Joshi, A.Y. 2019. Chronic norovirus infection in primary immune deficiency disorders: an international case series. Diagnostic Microbiology and Infectious Disease 93 (1) , pp. 69-73. 10.1016/j.diagmicrobio.2018.08.002

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Objective Predictive factors associated with clinical outcomes of chronic norovirus infection (CNI) in primary immunodeficiency diseases (PIDD) are lacking. Method We sought to characterize CNI using a multi-institutional cohort of patients with PIDD and CNI using the Clinical Immunology Society's CIS-PIDD Listserv e-mail group. Results Thirty-four subjects (21 males and 13 females) were reported from centers across North America, Europe, and Asia. All subjects were receiving high doses (median IgG dose: 1200 mg/kg/month) of supplemental immunoglobulin therapy. Fifty-three percent had a complete absence of B cells (median B-cell count 0; range 0–139 cells/μL). Common Variable Immune Deficiency (CVID) subjects manifested a unique phenotype with B-cell lymphopenia, non O+ blood type, and villous atrophy (logistic regression model, P = 0.01). Five subjects died, all of whom had no evidence of villous atrophy. Conclusion While Norovirus (NoV) is thought to replicate in B cells, in this PIDD cohort of CNI, B-cell lymphopenia was common, indicating that the presence of B lymphocytes is not essential for CNI.

Item Type: Article
Date Type: Publication
Status: Published
Schools: Medicine
Publisher: Elsevier
ISSN: 0732-8893
Date of Acceptance: 6 August 2018
Last Modified: 13 Feb 2019 14:15

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